Individual
CLEMENS ADEYEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1495 W 9TH ST, UPLAND, CA 91786-5640
(909) 210-9920
(909) 832-1008
Mailing address
PO BOX 2522, RANCHO CUCAMONGA, CA 91729-2522
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43485
—
CA
Enumeration date
09/25/2006
Last updated
07/09/2007
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