Individual provider Active NPI

Ijeoma H Ezemonye, NP

  • Nurse Practitioner
  • South Gate, CA
National Provider Identifier
1396257382
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95007825 Issued in CA
Practice address
5831 Firestone Blvd Ste E
South Gate, CA 90280-3718
Phone
(562) 806-7545
NPI assigned
Oct 30, 2017
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95007825 CA Primary

Addresses

Primary practice location

5831 Firestone Blvd Ste E
South Gate, CA 90280-3718

Mailing address

5831 Firestone Blvd Ste E
South Gate, CA 90280-3718
Phone (562) 806-7545

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180508001496 CA Practitioner - Nurse Practitioner 8527322148 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

4450 W Century Blvd
Inglewood, CA 90304-1504
Phone (310) 671-0555

5831 Firestone Blvd
Suite E
South Gate, CA 90280-3718
Phone (562) 806-7545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 18, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 18, 2023 Accepting new patients
El Dorado Community Service Centers CurrentSince Jan 19, 2021 Accepting new patients
El Dorado Community Service Center CurrentSince Jan 19, 2021 Accepting new patients
El Dorado Community Service Center Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

25821 Vermont Ave
Harbor City, CA 90710
Phone (424) 251-7100

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

4450 W Century Blvd
Inglewood, CA 90304
Phone (310) 671-0555

4023 Marine Ave
Lawndale, CA 90260
Phone (310) 508-8693

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

26460 Summit Cir
Santa Clarita, CA 91350
Phone (562) 916-7581

Interoperability endpoints

  • Direct secure messaging: iezemonye@ecsc.adaptamed.direct-ci.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1396257382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 FIRESTONE BLVD STE E",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803718",
            "telephone_number": "562-806-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5831 FIRESTONE BLVD STE E",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803718",
            "telephone_number": "562-806-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEMONYE",
        "first_name": "IJEOMA",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.