Individual
DR. OLUWAMUYIWA BOLONDURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
45104 10TH ST W, LANCASTER, CA 93534
(562) 867-7999
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01078198A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
C168133
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215216965
—
CA
01
—
191360022
MEDICARE PTAN
IN
05
—
300002192
—
IN
01
—
CA425840
MEDICARE
CA
Enumeration date
08/12/2011
Last updated
09/05/2023
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