OLATOKUNBO ADEGBORO (NPI# 1093100893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093100893 |
| Entity Type | Individual |
| Full Name | OLATOKUNBO ADEGBORO |
| Credential | MD |
| Practice Address |
4077 Fifth Ave # Mer35 San Diego CA 92103-2105 |
| Mailing Address |
5638 Murray Dr Berkeley IL 60163-1454 |
| Practice Telephone | 6192948111 |
| Mailing Telephone | 3122318226 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4077 FIFTH AVE # MER35 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306808464 | Eric Dahms | Internal Medicine | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2006-04-04 |
| 1528672532 | Orlando Manzano | Nurse Practitioner | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-09-07 |
| 1518570167 | Lindsay Gumm | Social Worker | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-08-24 |
| 1821608811 | Tammy V Pham, M.d., Apc | Obstetrics & Gynecology | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-08-04 |
| 1891310538 | Jordan Ray Noble | Nurse Practitioner | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-06-09 |
| 1861014714 | Merril Lindner | Dietetic Technician, Registered | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-14 |
| 1215559042 | Kevin Kavanagh | Pharmacist | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-14 |
| 1942821525 | Page Staley Hope Moore | Occupational Therapist | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-05 |
| 1316568033 | Brent Conrad Beckner | Pharmacist | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-05-04 |
| 1306474101 | Kate Hebert Pool | Student in an Organized Health Care Education/Training Program | 4077 Fifth Ave, San Diego, CA 92103-2105 | 2020-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716204 | Julianne A. Demery | Student in an Organized Health Care Education/Training Program | Naval Base San Diego 2450 Craven Street #3300, San Diego, CA 92136-0001 | 2020-10-01 |
| 1649885732 | Leanne Evalyn Morancie | Student in an Organized Health Care Education/Training Program | 4231 Balboa Ave # 1245, San Diego, CA 92117-5504 | 2020-09-15 |
| 1689288136 | Melissa Eileen Fitzgibbon | Student in an Organized Health Care Education/Training Program | 5114 63rd St, San Diego, CA 92115-1407 | 2020-09-02 |
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1861004392 | Mareena Biju | Student in an Organized Health Care Education/Training Program | 10995 Evening Creek Dr E, San Diego, CA 92128-4009 | 2020-08-17 |
| 1184235202 | Taylor G Wasko | Student in an Organized Health Care Education/Training Program | 4114 Swift Ave Apt 4, San Diego, CA 92104-2249 | 2020-08-12 |
| 1790394245 | Elisa Melo Da Silva Smerik | Student in an Organized Health Care Education/Training Program | 3235 Loma Riviera Dr, San Diego, CA 92110-5511 | 2020-07-29 |
| 1215554076 | Ana Mohammad-zadeh | Student in an Organized Health Care Education/Training Program | 17289 Russet St, San Diego, CA 92127-2135 | 2020-06-28 |
| 1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.