Provider Demographics
NPI:1093988800
Name:EKEKE, NANCY O (MD)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:O
Last Name:EKEKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 HASKELL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3121
Mailing Address - Country:US
Mailing Address - Phone:818-763-8836
Mailing Address - Fax:
Practice Address - Street 1:9119 HASKELL AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3121
Practice Address - Country:US
Practice Address - Phone:818-763-8836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA112956207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program