Organization Active NPI

Oyinda F Akenzua MD Inc

  • Primary Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1760728521
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A062206 Issued in CA
Legal business name
OYINDA F AKENZUA MD INC
Practice address
8540 S Sepulveda Blvd
Suite 150
Los Angeles, CA 90045-3807
Phone
(310) 417-4014
NPI assigned
Dec 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Authorized official

Name
Dr. Oyinda Akenzua, M.D.
Title
Medical Director
Phone
(310) 417-4014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A062206 CA Primary

Addresses

Primary practice location

8540 S Sepulveda Blvd
Suite 150
Los Angeles, CA 90045-3807

Mailing address

8540 S Sepulveda Blvd
Suite 150
Los Angeles, CA 90045-3807
Phone (310) 417-4014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130110000284 CA Part B Supplier - Clinic/Group Practice 6406009026 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2127616Oyinda F Akenzua MD, Inc.8540 S Sepulveda Blvd Ste 150, Los Angeles, CA 90045Certificate of waiverMar 14, 2027

National Provider Directory

National Provider Directory

Locations

8540 S Sepulveda Blvd
Ste 150
Los Angeles, CA 90045
Phone (310) 417-4014

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1760728521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "SUITE 150",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-417-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "SUITE 150",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-417-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OYINDA F AKENZUA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "AKENZUA",
        "authorized_official_first_name": "OYINDA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-417-4014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A062206",
            "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 Dec 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.