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1467178947
TAIWO ODUKOYA ODUTOLA
CARSON, CA
NPI
1467178947
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA 95022131)
Enumeration Date
2022-10-17
Last Update Date
2023-12-19
Business Address
TAIWO ODUKOYA ODUTOLA OWNER
21880 ORRICK AVE
CARSON, CA 90745-3052
Phone number: 310-927-2119
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Mailing Address
TAIWO ODUKOYA ODUTOLA OWNER
21880 ORRICK AVE
CARSON, CA 90745-3052
Phone number: 310-927-2119
Copy
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