Provider Demographics
NPI:1477895860
Name:TAIWO, ADEFEMI (MD)
Entity Type:Individual
Prefix:
First Name:ADEFEMI
Middle Name:
Last Name:TAIWO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 CALIFORNIA AVE STE 400B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7081
Mailing Address - Country:US
Mailing Address - Phone:717-531-0003
Mailing Address - Fax:661-237-6650
Practice Address - Street 1:4900 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7024
Practice Address - Country:US
Practice Address - Phone:661-459-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-23
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1552832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry