MEDICARE: SUNDAY IFEANYI MADU

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	F02260840	CA

General Provider Information

NPI Number	:	1619821717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNDAY IFEANYI MADU

Provider Business Mailing Address
First Line	:	11149 CRENSHAW BLVD
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90303-2338
Country	:	US
Telephone Number	:	310-808-8494
Fax Number	:

Provider Business Practice Location Address
First Line	:	11149 CRENSHAW BLVD
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90303-2338
Country	:	US
Telephone Number	:	310-808-8494
Fax Number	:

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

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	05/11/2026

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