Individual provider Active NPI

Obidi Obienu

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1780007179
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000186 Issued in CA
Practice address
1200 N State St
Los Angeles, CA 90033-1029
Phone
(323) 409-1000
Fax
(323) 441-8079
NPI assigned
Jan 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000186 CA Primary

Addresses

Primary practice location

1200 N State St
Los Angeles, CA 90033-1029

Mailing address

7723 Dalton Ave
Los Angeles, CA 90047-2510

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
I20221206002455 CA Practitioner - Nurse Practitioner 5698142107 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nursing Trend Care Health Corporation CurrentSince Jun 29, 2025 Accepting new patients
Comprehensive Psychiatric Services, a Medical Group CurrentSince Sep 1, 2024 Accepting new patients

Locations

6167 Bristol Pkwy
Ste 260
Culver City, CA 90230
Phone (424) 331-5604

3100 Oak Rd
Ste 270
Walnut Creek, CA 94597
Phone (925) 944-9711

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1780007179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7723 DALTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-1000",
            "fax_number": "323-441-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIENU",
        "first_name": "OBIDI",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.