Provider Demographics
NPI:1144517806
Name:NDOLO, CHIGOZIE (DPT)
Entity type:Individual
Prefix:DR
First Name:CHIGOZIE
Middle Name:
Last Name:NDOLO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:GOZIE
Other - Middle Name:
Other - Last Name:NDOLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-0235
Mailing Address - Country:US
Mailing Address - Phone:310-539-8800
Mailing Address - Fax:
Practice Address - Street 1:559 E CARSON ST STE B
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2721
Practice Address - Country:US
Practice Address - Phone:310-539-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1208296225100000X
CA297832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist