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NPI Code Detail

MEDICARE: DR. ODEY CHUKWUEMEKA UKPO MD

MEDICARE:  DR. ODEY CHUKWUEMEKA UKPO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician2009012284MO
2390200000XStudent in an Organized Health Care Education/Training ProgramNM
3207ZF0201XForensic Pathology PhysicianA129278CA

General Provider Information

NPI Number : 1245469444
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ODEY CHUKWUEMEKA UKPO MD
Provider Business Mailing Address
First Line : 1104 N MISSION RD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1104 N MISSION RD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1017
Country : US
Telephone Number : 323-343-0512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 09/16/2015

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