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NPI Code Detail

MEDICARE: LYDIA OWUOR

MEDICARE: LYDIA OWUOR
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
1225400000XRehabilitation Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner95023366CA

General Provider Information

NPI Number : 1700080744
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA OWUOR
Provider Business Mailing Address
First Line : 2500 WILSHIRE BLVD STE 500
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-4310
Country : US
Telephone Number : 213-639-0242
Fax Number :
Provider Business Practice Location Address
First Line : 2500 WILSHIRE BLVD STE 500
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-4310
Country : US
Telephone Number : 213-639-0242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 01/12/2024

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Directions to “ LYDIA OWUOR ” Practice Location

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