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Contact Information

JERRY A OKONKWOAGUOLU, MD
15603 HAWTHORNE BLVD
LAWNDALE, CA90260-2639
 Phone: 310-644-4488
 Fax: 310-679-4035
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Occupational Medicine

2083X0100X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for JERRY A OKONKWOAGUOLU · (Male)

NPI # 1134239932
Status Active
Credentials MD
Entity Individual
Enumeration date 08/30/2006
Last updated 06/03/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A29427
  • CA Medicaid A294270
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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