Provider Demographics
NPI:1326743360
Name:OSINFOLARIN, OLUWATOMISIN PHILIP (DC)
Entity Type:Individual
Prefix:
First Name:OLUWATOMISIN
Middle Name:PHILIP
Last Name:OSINFOLARIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:TOMI
Other - Middle Name:
Other - Last Name:OSIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1566 CALLE DE LA FLOR # 2
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-2505
Mailing Address - Country:US
Mailing Address - Phone:619-609-4246
Mailing Address - Fax:
Practice Address - Street 1:7822 CONVOY CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1210
Practice Address - Country:US
Practice Address - Phone:858-997-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty