| Omni Medical Health Group Inc | |
|
1159 S Lorena St Los Angeles CA 90023-2926 | |
| (323) 881-6465 | |
| (323) 261-8768 |
| Full Name | Omni Medical Health Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1159 S Lorena St, Los Angeles, California |
| Authorized Official Name and Position | Manasseh C Nwaigwe (PRESIDENT) |
| Authorized Official Contact | 3238816465 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Medical Health Group Inc Po Box 479 Monterey Park CA 91754-0479 Ph: (323) 881-6465 | Omni Medical Health Group Inc 1159 S Lorena St Los Angeles CA 90023-2926 Ph: (323) 881-6465 |
| NPI Number | 1063569614 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 12/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063569614 | NPI | - | NPPES |
| 00A425320 | Medicaid | CA | |
| AV913 | Other | CA | PTAN |
| 1063569614 | Other | CA | NPI |
| AV913 | Other | CA | MEDICARE PTAN |
| AV913A | Other | CA | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A42532 (California) | Primary |
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