Individual
OLALEKAN MONSURU EJALONIBU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1929 PICASSO WAY, STOCKTON, CA 95206-6052
(209) 390-3274
Mailing address
1929 PICASSO WAY, STOCKTON, CA 95206-6052
(209) 390-3274
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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