MEDICARE: EZINNE OZOUDE

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	183500000X	Pharmacist	65185	CA

General Provider Information

NPI Number	:	1700285467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EZINNE OZOUDE

Provider Business Mailing Address
First Line	:	6802 NIXON ST
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-2809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6802 NIXON ST
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-2809
Country	:	US
Telephone Number	:	323-750-5222
Fax Number	:	323-750-1245

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

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	08/19/2014

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Directions to “ EZINNE OZOUDE ” Practice Location

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