Individual
ANYIAM S OHAERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14023 CRENSHAW BLVD STE 3, HAWTHORNE, CA 90250-9255
(310) 679-1319
(310) 679-1719
Mailing address
PO BOX 881185, LOS ANGELES, CA 90009-7185
(310) 679-1319
(310) 679-1719
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
102608
CA
Other
Enumeration date
12/19/2005
Last updated
02/01/2008
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