Individual provider Active NPI

Chukwudi Nnamdi Ezeunala

  • Durable Medical Equipment & Medical Supplies
  • Los Angeles, CA
National Provider Identifier
1881623593
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
43755 Issued in CA
Practice address
1957 W Manchester Ave
Los Angeles, CA 90047-2924
Phone
(323) 752-3031
Fax
(323) 752-3132
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 43755 CA Primary

Addresses

Primary practice location

1957 W Manchester Ave
Los Angeles, CA 90047-2924

Mailing address

1957 W Manchester Ave
Los Angeles, CA 90047-2924
Phone (323) 752-3031

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

State licenses

LicenseStateTypeSpecialty
43755CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Chukwudi Nnamdi Ezeunala Durable Medical Equipment & Medical Supplies Past Accepting new patients
Sammys Medical Supply Inc Durable Medical Equipment & Medical Supplies Past Accepting new patients

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1881623593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472924",
            "telephone_number": "323-752-3031",
            "fax_number": "323-752-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472924",
            "telephone_number": "323-752-3031",
            "fax_number": "323-752-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEUNALA",
        "first_name": "CHUKWUDI",
        "middle_name": "NNAMDI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "43755",
            "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 Jun 19, 2008; 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.