Provider Demographics
NPI:1992986947
Name:ANAKWENZE, VICKI MARIE (MD,)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:MARIE
Last Name:ANAKWENZE
Suffix:
Gender:F
Credentials:MD,
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Mailing Address - Street 1:5260 S FIGUEROA ST
Mailing Address - Street 2:216
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-3743
Mailing Address - Country:US
Mailing Address - Phone:323-234-3077
Mailing Address - Fax:323-234-2431
Practice Address - Street 1:5260 S FIGUEROA ST
Practice Address - Street 2:216
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-3743
Practice Address - Country:US
Practice Address - Phone:323-234-3077
Practice Address - Fax:323-234-2431
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2011-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG61291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G61291Medicaid
CA00G61291Medicaid