Organization
CHARLES I OKONKWO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES IFEANYI OKONKWO M.D. (PRESIDENT)
(323) 234-7200
Entity
Organization
Contact information
Practice address
231 W VERNON AVE, SUITE 105, LOS ANGELES, CA 90037-2700
(323) 234-7200
(323) 234-1922
Mailing address
231 W VERNON AVE, SUITE 105, LOS ANGELES, CA 90037-2700
(323) 234-7200
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A31084
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A310840
—
CA
01
—
W5103B
MEDICARE GROUP
CA
Enumeration date
02/06/2008
Last updated
04/19/2011
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