Provider Demographics
NPI:1669653044
Name:OGBENI, ADONIS (REGISTERED NURSE)
Entity Type:Individual
Prefix:MR
First Name:ADONIS
Middle Name:
Last Name:OGBENI
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18020 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5112
Mailing Address - Country:US
Mailing Address - Phone:310-532-2487
Mailing Address - Fax:310-532-2694
Practice Address - Street 1:302 E MANCHESTER BLVD
Practice Address - Street 2:2
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1815
Practice Address - Country:US
Practice Address - Phone:310-532-2487
Practice Address - Fax:310-532-2694
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA678770163WH0200X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice