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Organization
JERRY A OKONKWOAGUOLU MD
Active
Organization
JERRY A OKONKWOAGUOLU MD
Active
Other names
Jeremiah A. O. Aguolu MD
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY A OKONKWOAGUOLU (PRESIDENT)
(310) 644-4488
Entity
Organization
Contact information
Practice address
15603 HAWTHORNE BLVD, LAWNDALE, CA 90260-2639
(310) 644-4488
(310) 679-4035
Mailing address
15603 HAWTHORNE BLVD, LAWNDALE, CA 90260-2639
(310) 644-4488
(310) 679-4035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Enumeration date
06/30/2010
Last updated
08/03/2010
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