Organization
BABATUNDE A. EBOREIME, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BABATUNDE A. EBOREIME M.D. (OWNER)
(626) 791-4692
Entity
Organization
Contact information
Practice address
2595 E WASHINGTON BLVD, SUITE 105, PASADENA, CA 91107-1409
(626) 791-4692
(626) 791-7699
Mailing address
2595 E WASHINGTON BLVD, SUITE 105, PASADENA, CA 91107-1409
(626) 791-4692
(626) 791-7699
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G29988
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009299880
—
CA
Enumeration date
02/23/2014
Last updated
02/23/2014
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