Provider Demographics
NPI:1407297021
Name:IHEME, SYLVANUS
Entity Type:Individual
Prefix:
First Name:SYLVANUS
Middle Name:
Last Name:IHEME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 CRENSHAW BLVD
Mailing Address - Street 2:229
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008
Mailing Address - Country:US
Mailing Address - Phone:323-290-9910
Mailing Address - Fax:323-290-9911
Practice Address - Street 1:3890 CRENSHAW BLVD
Practice Address - Street 2:229
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008
Practice Address - Country:US
Practice Address - Phone:323-290-9910
Practice Address - Fax:323-290-9911
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor