Individual
BUKOLA DEBORAH OLUSANYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
(323) 541-1499
Mailing address
960 W 62ND PL, APT. 243, LOS ANGELES, CA 90044-5474
(323) 440-9196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95004381
CA
Other
Enumeration date
06/01/2016
Last updated
09/06/2016
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