Individual
ANTHONY OTEGBULU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4951 MARINE AVE, LAWNDALE, CA 90260-1250
(310) 263-3264
Mailing address
PO BOX 71, LAWNDALE, CA 90260-0071
(310) 283-9454
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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