Provider Demographics
NPI:1548591019
Name:OSHINUGA, GBEMISOLA
Entity Type:Individual
Prefix:
First Name:GBEMISOLA
Middle Name:
Last Name:OSHINUGA
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 1:1814 E HELMICK ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2517
Mailing Address - Country:US
Mailing Address - Phone:562-361-2120
Mailing Address - Fax:
Practice Address - Street 1:1814 E HELMICK ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-2517
Practice Address - Country:US
Practice Address - Phone:562-361-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-23
Last Update Date:2010-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 223791164X00000X
CA163WH1000X164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse