Provider Demographics
NPI:1003194416
Name:OKOH, GLORIA NGOZI (NP)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:NGOZI
Last Name:OKOH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:NGOZI
Other - Last Name:NWAGWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:869 E GLADWICK ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3818
Mailing Address - Country:US
Mailing Address - Phone:310-908-0601
Mailing Address - Fax:
Practice Address - Street 1:349 W COMPTON BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3110
Practice Address - Country:US
Practice Address - Phone:310-438-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19881363LF0000X
CA19661363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily