Provider Demographics
NPI:1487008082
Name:EZIMORA, CANDY OBIAGELI (MD)
Entity type:Individual
Prefix:DR
First Name:CANDY
Middle Name:OBIAGELI
Last Name:EZIMORA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:757 WESTWOOD PLZ STE 3304
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8358
Mailing Address - Country:US
Mailing Address - Phone:310-267-8653
Mailing Address - Fax:310-267-3766
Practice Address - Street 1:757 WESTWOOD PLZ STE 3304
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8358
Practice Address - Country:US
Practice Address - Phone:310-267-8653
Practice Address - Fax:310-267-3766
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC218062207L00000X
CAA166500207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology