Individual
OMONIYI TEMITOPE AKINTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
4001 HWY 104, IONE, CA 95640
(209) 274-4911
Mailing address
6330 LAGUNA VILLA WAY, ELK GROVE, CA 95758-4735
(916) 549-9029
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16410
CA
Other
Enumeration date
12/14/2007
Last updated
12/14/2007
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