Individual
DR. OLUWASEYI SEGUN BALASIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5305
(510) 727-3256
(510) 727-3107
Mailing address
400 CHANEY RD APT 307, SMYRNA, TN 37167-2650
(813) 389-8614
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1118626
CA
207R00000X
Internal Medicine Physician
56261
TN
208M00000X
Hospitalist Physician
Primary
A152926
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1118626
AMERICAN BOARD OF INTERNAL MEDICINE
CA
01
—
A152926
STATE MEDICAL LICENSE
CA
Enumeration date
04/15/2014
Last updated
03/07/2023
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