Provider Demographics
NPI:1497326789
Name:MEDCOM GLOBAL INC.
Entity Type:Organization
Organization Name:MEDCOM GLOBAL INC.
Other - Org Name:MEDCOM PSYCHIATRY & MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:OGBONNA
Authorized Official - Middle Name:IWUAMADI
Authorized Official - Last Name:OLELEWE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP, FNP
Authorized Official - Phone:562-277-2586
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90714-0507
Mailing Address - Country:US
Mailing Address - Phone:562-277-2586
Mailing Address - Fax:
Practice Address - Street 1:11712 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2324
Practice Address - Country:US
Practice Address - Phone:562-277-2586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty