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Organization
OMNI MEDICAL HEALTH GROUP INC
Active
Organization
OMNI MEDICAL HEALTH GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANASSEH C NWAIGWE M.D. (PRESIDENT)
(323) 881-6465
Entity
Organization
Contact information
Practice address
1159 S LORENA ST, LOS ANGELES, CA 90023-2926
(323) 881-6465
(323) 261-8768
Mailing address
PO BOX 479, MONTEREY PARK, CA 91754-0479
(323) 881-6465
(323) 261-8768
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A42532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A425320
—
CA
01
—
1063569614
NPI
CA
01
—
AV913
PTAN
CA
01
—
AV913A
PTAN
CA
Enumeration date
01/05/2007
Last updated
12/20/2010
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