Provider Demographics
NPI:1972624021
Name:AWARIEFE, STANISLAUS OKPAKO (MD)
Entity Type:Individual
Prefix:DR
First Name:STANISLAUS
Middle Name:OKPAKO
Last Name:AWARIEFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HENRY
Other - Middle Name:OKPAKO
Other - Last Name:AWARIEFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1039 W FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-2441
Mailing Address - Country:US
Mailing Address - Phone:323-776-1500
Mailing Address - Fax:323-776-1499
Practice Address - Street 1:1039 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-2441
Practice Address - Country:US
Practice Address - Phone:323-776-1500
Practice Address - Fax:323-776-1499
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28705207Q00000X, 207R00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery