Provider Demographics
NPI:1831450519
Name:PRIEST, NNEAMAKA AJALLA (MD)
Entity type:Individual
Prefix:
First Name:NNEAMAKA
Middle Name:AJALLA
Last Name:PRIEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NNEAMAKA
Other - Middle Name:
Other - Last Name:AJALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:321 N LARCHMONT BLVD STE 1020
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-6410
Mailing Address - Country:US
Mailing Address - Phone:323-960-8500
Mailing Address - Fax:323-960-8585
Practice Address - Street 1:321 N LARCHMONT BLVD STE 1020
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-6410
Practice Address - Country:US
Practice Address - Phone:323-960-8500
Practice Address - Fax:323-960-8585
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29242208000000X
CAA151054208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics