Ifeoma S Izuchukwu MD, a Prof Med Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A80750 Issued in CA

Legal business name

IFEOMA S IZUCHUKWU MD, A PROF MED CORP

Practice address

8540 S Sepulveda Blvd
Ste 116
Los Angeles, CA 90045-3807

Phone

(888) 664-1121

Fax

(310) 362-0390

NPI assigned

Feb 25, 2011

Organization subpart

No

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

Authorized official

Name

Ifeoma Izuchukwu, M.D

Title

MD/Owner

Phone

(888) 664-1121

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1811294952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13042",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902954042",
            "telephone_number": "888-664-1121",
            "fax_number": "310-362-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "STE 116",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "888-664-1121",
            "fax_number": "310-362-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IFEOMA S IZUCHUKWU MD, A PROF MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "IZUCHUKWU",
        "authorized_official_first_name": "IFEOMA",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "888-664-1121",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A80750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.