Individual
SAMUSIDEEN ENIGBOKAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9808 VENICE BLVD, SUITE700, CULVER CITY, CA 90232-2732
(310) 945-3350
(310) 840-7023
Mailing address
9808 VENICE BLVD, SUITE700, CULVER CITY, CA 90232-2732
(310) 945-3350
(310) 840-7023
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
560914
CA
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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