Individual
DR. ALOYSIUS IFEANYI UDEZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, BSC, IDE, DABDA.
Contact information
Practice address
12613 VENICE BLVD, 13523 LEMOLI AVENUE HAWTHORNE, CA 90250, LOS ANGELES, CA 90066-3703
(310) 390-9293
(323) 820-1718
Mailing address
11012 CHANERA AVE, INGLEWOOD, CA 90303-2427
(310) 390-9293
(323) 820-1718
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC24645
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0246450
DOCTOR'S BLUE SHIELD PIN#
CA
01
—
WDC24645B CA
MEDICARE W18417 CA
CA
01
—
ZZZ64099Z
ZZZ64099Z CA
CA
Enumeration date
10/24/2006
Last updated
12/07/2015
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