MEDICARE: UCHECHI L NWOSU-IROHA NP

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
1	363LF0000X	Family Nurse Practitioner	95003533	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95003533	OTHER	CA	FNP LICENSE ISSUED BY CA BRN

General Provider Information

NPI Number	:	1306211081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UCHECHI L NWOSU-IROHA NP

Provider Business Mailing Address
First Line	:	630 VENICE WAY
Second Line	:	208
City	:	INGLEWOOD
State	:	CA
Zip	:	90302-2845
Country	:	US
Telephone Number	:	310-722-1728
Fax Number	:

Provider Business Practice Location Address
First Line	:	10121 WASHINGTON ST
Second Line	:
City	:	BELLFLOWER
State	:	CA
Zip	:	90706-3228
Country	:	US
Telephone Number	:	310-722-1782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	10/31/2022

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