Provider Demographics
NPI:1295864684
Name:ARE, ESTHER OMOLAYO
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:OMOLAYO
Last Name:ARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15342 HAWHTORNE BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2152
Mailing Address - Country:US
Mailing Address - Phone:310-675-3426
Mailing Address - Fax:310-675-3426
Practice Address - Street 1:15342 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2152
Practice Address - Country:US
Practice Address - Phone:310-675-3426
Practice Address - Fax:310-675-3426
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47196332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5954100001Medicare NSC