Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Ejiogu

Individual provider Family Nurse Practitioner · NPI 1639647019

Kenneth Ejiogu is a Nurse Practitioner in Los Angeles, California. Qualified in 2017, 9 years ago. Practices with Healthcare Partners Affiliates Medical Group, a 790-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2018
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Practice location Address checks out

1127 Wilshire Blvd Ste 800
Los Angeles, CA 90017-3909
Phone: (213) 839-1119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10565 Civic Center Dr, Rancho Cucamonga, CA 91730-3853 — (469) 237-7389

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95011746 (CA)

Record details

NPI number1639647019
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 5, 2018
Last updated in NPPESApril 8, 2025
Certification dateApril 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Healthcare Partners Affiliates Medical Group — 790 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Los Angeles