Individual provider Active NPI

Ogochukwu Ike

  • Primary Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1265041347
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
14640 Issued in CA
Practice address
450 Bauchet St
Los Angeles, CA 90012-2907
Phone
(213) 893-2156
NPI assigned
Jul 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 14640 CA Primary

Addresses

Primary practice location

450 Bauchet St
Los Angeles, CA 90012-2907

Mailing address

23701 Oak Cir
Newhall, CA 91321-4627
Phone (661) 600-5408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1265041347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23701 OAK CIR",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913214627",
            "telephone_number": "661-600-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "213-893-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKE",
        "first_name": "OGOCHUKWU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "14640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.