Individual
OLATUNDE BOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
39407 VISTA DEL SOL, RANCHO MIRAGE, CA 92270-3283
(760) 773-4130
(607) 773-1374
Mailing address
39407 VISTA DEL SOL, RANCHO MIRAGE, CA 92270-3283
(760) 773-4130
(760) 773-1374
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD462235
PA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
A177863
CA
Other
Enumeration date
07/01/2014
Last updated
02/20/2023
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