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NPI Code Detail

MEDICARE: COSMAS N. NWOSU PA

MEDICARE: COSMAS N. NWOSU PA
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
1363AM0700XMedical Physician AssistantPA#17230CA

General Provider Information

NPI Number : 1568502581
Entity Type Code : Individual
Provider Name (Legal Business Name) : COSMAS N. NWOSU PA
Provider Business Mailing Address
First Line : BAART 1926 WEST BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057
Country : US
Telephone Number : 213-607-2010
Fax Number : 213-607-1434
Provider Business Practice Location Address
First Line : 1926 BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2402
Country : US
Telephone Number : 213-607-2010
Fax Number : 213-607-1434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 01/19/2018

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