Jerry a Okonkwoaguolu MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JERRY A OKONKWOAGUOLU MD

Doing business as

Jeremiah A. O. Aguolu MD

Practice address

15603 Hawthorne Blvd
Lawndale, CA 90260-2639

Phone

(310) 644-4488

Fax

(310) 679-4035

NPI assigned

Jun 30, 2010

Organization subpart

No

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

Authorized official

Name

Jerry A Okonkwoaguolu

Title

President

Phone

(310) 644-4488

Specialties & licenses 3

Addresses

Other names 1

• Jeremiah A. O. Aguolu MD Doing business as

Locations

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1730490137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15603 HAWTHORNE BLVD",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602639",
            "telephone_number": "310-644-4488",
            "fax_number": "310-679-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15603 HAWTHORNE BLVD",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602639",
            "telephone_number": "310-644-4488",
            "fax_number": "310-679-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY A OKONKWOAGUOLU MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "OKONKWOAGUOLU",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-644-4488"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeremiah A. O. Aguolu MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randall Ito
• Philippa Jacobs, N.P.
• Marisa Jantzen
• Jason H. Ta, DMD, Inc.
• Jehovah-Jireh Medical Supplies Inc.
• Laura Lonwah Jin
• Sangsik Jin, L.AC.
• Jodi L. Clark O.D.
• Robert T Johnson, MASSAGE LICENSE
• Autumn Jones

• Family Medicine Physician in Lawndale, CA
• Providers in Lawndale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.