Organization
KINGSLEY O. OFOEGBU MD, FACP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEBASTINE E. CHIKEZIE N.P. (NURSE PRACTITIONER)
(310) 982-3141
Entity
Organization
Contact information
Practice address
644 E REGENT ST STE 200, INGLEWOOD, CA 90301-1444
(310) 982-3141
Mailing address
20111 WADLEY AVE, CARSON, CA 90746-3046
(310) 982-3141
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
688400
CA
3140N1450X
Pediatric Skilled Nursing Facility
688400
CA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
688400
CA
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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