Provider Demographics
NPI:1326792128
Name:OLUSEYI AWODELE M.D.
Entity Type:Organization
Organization Name:OLUSEYI AWODELE M.D.
Other - Org Name:BRAINCARE PERFORMANCE CENTER CARLSBAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OLUSEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:AWODELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-452-6387
Mailing Address - Street 1:3257 CAMINO DE LOS COCHES STE 305
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8974
Mailing Address - Country:US
Mailing Address - Phone:760-452-6387
Mailing Address - Fax:833-330-2628
Practice Address - Street 1:3257 CAMINO DE LOS COCHES STE 305
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8974
Practice Address - Country:US
Practice Address - Phone:619-940-6269
Practice Address - Fax:833-330-2683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty