Individual
EDAFE LANS ALEX IKPURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
924 GAVIOTA AVE APT 202, LONG BEACH, CA 90813-6314
(562) 485-1156
Mailing address
924 GAVIOTA AVE APT 202, LONG BEACH, CA 90813-6314
(562) 485-1156
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
01210033
CA
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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