Angela Ugochi Otegbulu, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014215 Issued in CA

Practice address

13812 Spinning Ave
Gardena, CA 90249-2365

Phone

(310) 529-4211

NPI assigned

Apr 1, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

ZenmedicineGroup PAC ID 3577800390, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713
  Medicare reassignment Care Compare group NPD
• Zenmedicine

  • General Practice Physician
  • West Covina, CA
  • NPI 1821567488
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1073142121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DONE ADDRESS: 2029 CENTURY PARK EAST, SUITE 400",
            "address_2": "OFFICE #422",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90067",
            "telephone_number": "310-529-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13812 SPINNING AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492365",
            "telephone_number": "310-529-4211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Done Address: 2029 Century Park East, Suite 400",
            "address_2": "Office #422",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90067",
            "country_code": "US",
            "telephone_number": "310-529-4211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTEGBULU",
        "first_name": "ANGELA",
        "middle_name": "UGOCHI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Oshimo, PT, DPT
• Chidiebere Louis Osondu
• Sylvia Osorio, M.D.
• George Raymond Osuna, SUD COUNSELOR
• Alec Ota, NONE
• Alina Otero
• Citlali Otero
• Rebecca Otero
• Cremisha La Quiche Overton
• Owen L. Robinson MD, a Medical Corporation

• Family Nurse Practitioner in Gardena, CA
• Providers in Gardena, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.