Provider Demographics
NPI:1124404207
Name:AKINTUNJI, KEHINDE (NP)
Entity Type:Individual
Prefix:
First Name:KEHINDE
Middle Name:
Last Name:AKINTUNJI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15603 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2639
Mailing Address - Country:US
Mailing Address - Phone:310-644-4488
Mailing Address - Fax:310-679-4035
Practice Address - Street 1:15603 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2639
Practice Address - Country:US
Practice Address - Phone:310-644-4488
Practice Address - Fax:310-679-4035
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20920363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily