Provider Demographics
NPI:1457047722
Name:IZUCHUKWU OKPARA MD, P.A.
Entity Type:Organization
Organization Name:IZUCHUKWU OKPARA MD, P.A.
Other - Org Name:OMNI WOUND PHYSICIANS FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:IZUCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:OKPARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-228-3538
Mailing Address - Street 1:25044 PEACHLAND AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-5730
Mailing Address - Country:US
Mailing Address - Phone:661-934-0873
Mailing Address - Fax:818-356-4380
Practice Address - Street 1:1111 SW 1ST AVE APT 1922N
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-5406
Practice Address - Country:US
Practice Address - Phone:213-228-3538
Practice Address - Fax:818-356-4380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty