Charles I Okonkwo MD Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A31084 Issued in CA

Legal business name

CHARLES I OKONKWO MD INC

Practice address

231 W Vernon Ave
Suite 105
Los Angeles, CA 90037-2700

Phone

(323) 234-7200

Fax

(323) 234-1922

NPI assigned

Feb 6, 2008

Last updated

Apr 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Ifeanyi Okonkwo, M.D.NPI 1063550234

Title

President

Phone

(323) 234-7200

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles I Okonkwo, M.D.

  • Cardiovascular Disease Physician
  • Los Angeles, CA
  • NPI 1063550234
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1215115704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 W VERNON AVE",
            "address_2": "SUITE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372700",
            "telephone_number": "323-234-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 W VERNON AVE",
            "address_2": "SUITE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372700",
            "telephone_number": "323-234-7200",
            "fax_number": "323-234-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES I OKONKWO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "OKONKWO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "IFEANYI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-234-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A31084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "W5103B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A310840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.