MEDICARE: COMFORT N OJUKWU

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	95011955	CA

General Provider Information

NPI Number	:	1740841774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COMFORT N OJUKWU

Provider Business Mailing Address
First Line	:	639 E LINCOLN ST
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-6009
Country	:	US
Telephone Number	:	310-425-4058
Fax Number	:

Provider Business Practice Location Address
First Line	:	639 E LINCOLN ST
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-6009
Country	:	US
Telephone Number	:	310-425-4058
Fax Number	:

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

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	06/20/2019

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Directions to “ COMFORT N OJUKWU ” Practice Location

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