Basic Information
| Provider Information | |||||||||
| NPI: | 1285197905 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OKAFOR | ||||||||
| FirstName: | CHUKWUEMEKA | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | OKAFOR | ||||||||
| OtherFirstName: | EMEKA | ||||||||
| OtherMiddleName: | JOHN | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 757 WESTWOOD PLAZA, RADIOLOGY | ||||||||
| Address2: | SUITE 1638 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900957419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102678796 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 757 WESTWOOD PLAZA, RADIOLOGY | ||||||||
| Address2: | SUITE 1638 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900957419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102678796 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2019 | ||||||||
| LastUpdateDate: | 04/09/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.