Provider Demographics
NPI:1518464486
Name:NNADOZIE, UGOCHI
Entity Type:Individual
Prefix:
First Name:UGOCHI
Middle Name:
Last Name:NNADOZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 W REDONDO BEACH BLVD UNIT 3668
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-6592
Mailing Address - Country:US
Mailing Address - Phone:424-646-0847
Mailing Address - Fax:
Practice Address - Street 1:1455 W REDONDO BEACH BLVD UNIT 3668
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-6592
Practice Address - Country:US
Practice Address - Phone:424-646-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF03180116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily