Individual
OLUSEGUN ADETUYI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1619
Mailing address
PO BOX 3514, REDONDO BEACH, CA 90277-1514
(559) 572-2583
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A122119
CA
208M00000X
Hospitalist Physician
A122119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A122119
CA LICENSE
CA
Enumeration date
05/06/2010
Last updated
01/15/2024
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