Individual
LAWAL ABIODUN IBRAHIM-BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 N D ST, SUITE 14, SAN BERNARDINO, CA 92405-4722
(909) 386-3657
(909) 388-9173
Mailing address
1525 N D ST, SUITE 14, SAN BERNARDINO, CA 92405-4722
(909) 386-3657
(909) 388-9173
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
48762
CA
Other
Enumeration date
02/19/2008
Last updated
03/02/2011
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