Tracy Nwajuaku, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1076110 Issued in CA

Practice address

6316 Holmes Ave
Los Angeles, CA 90001-1824

Phone

(323) 583-5887

Fax

(323) 583-6601

NPI assigned

Oct 31, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1295914786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6316 HOLMES AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900011824",
            "telephone_number": "323-583-5887",
            "fax_number": "323-583-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6316 HOLMES AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900011824",
            "telephone_number": "323-583-5887",
            "fax_number": "323-583-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAJUAKU",
        "first_name": "TRACY",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA1076110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA1076110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry U Nwafor Sr., NP
• Henrietta Chinwendu Nwaibe, NP
• Manasseh C Nwaigwe, M.D
• Blessing Nwajuaku
• Patricia Ifeoma Nwajuaku, M.D., MPH
• Samuel Nwakpuda
• Erica Chiamaka Nwankwo
• Oluchi Nwankwo
• Ezeka Nwanyanwu
• Donald O Nwanze, PHARMD

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.