Provider Demographics
NPI:1417295700
Name:AKILO, ADENOLA AKEEM ADEYINKA
Entity Type:Individual
Prefix:DR
First Name:ADENOLA AKEEM
Middle Name:ADEYINKA
Last Name:AKILO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9083 RICHBOROUGH WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1304
Mailing Address - Country:US
Mailing Address - Phone:916-835-9281
Mailing Address - Fax:
Practice Address - Street 1:9083 RICHBOROUGH WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1304
Practice Address - Country:US
Practice Address - Phone:916-835-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist