Active NPI
Obinwanne Ikenna Darrell Enewally
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1538842984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88140
- Practice address
- 5837 S Central Ave
Los Angeles, CA 90001-1127 - Phone
- (323) 233-2493
- NPI assigned
- Aug 11, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 88140 | CA | Primary |
Addresses
Primary practice location
5837 S Central Ave
Los Angeles, CA 90001-1127
Mailing address
12147 Cedarvale St
Norwalk, CA 90650-7263
Phone (562) 200-9740
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": "1691712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1538842984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12147 CEDARVALE ST",
"city": "NORWALK",
"state": "CA",
"postal_code": "906507263",
"telephone_number": "562-200-9740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5837 S CENTRAL AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900011127",
"telephone_number": "323-233-2493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENEWALLY",
"first_name": "OBINWANNE",
"middle_name": "IKENNA DARRELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-11",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "88140",
"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 Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.