Organization
AIYEGBUSI AND BRAIMAH MEDICAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MODUPE AIYEGBUSI MD (PRESIDENT)
(310) 540-7240
Entity
Organization
Contact information
Practice address
3661 TORRANCE BLVD, SUITE 103, TORRANCE, CA 90503-4812
(310) 540-7240
(310) 540-7280
Mailing address
3661 TORRANCE BLVD, SUITE 103, TORRANCE, CA 90503-4812
(310) 540-7240
(310) 540-7280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090260
—
CA
Enumeration date
09/20/2006
Last updated
01/08/2014
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