Provider Demographics
NPI:1558573220
Name:OLAJIDE, GBOLAHAN A (DC)
Entity Type:Individual
Prefix:DR
First Name:GBOLAHAN
Middle Name:A
Last Name:OLAJIDE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:817 S MAIN ST
Mailing Address - Street 2:STE B
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3421
Mailing Address - Country:US
Mailing Address - Phone:951-273-9080
Mailing Address - Fax:951-273-9083
Practice Address - Street 1:817 S MAIN ST
Practice Address - Street 2:STE B
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3421
Practice Address - Country:US
Practice Address - Phone:951-273-9080
Practice Address - Fax:951-273-9083
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20459111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner