Individual
GRACE EBENUWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(310) 668-4506
(310) 763-8909
Mailing address
1731 STEARNS DR, LOS ANGELES, CA 90035-4627
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN401793
CA
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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