Provider Demographics
NPI:1568700086
Name:APARA, KEHINDE U
Entity Type:Individual
Prefix:MISS
First Name:KEHINDE
Middle Name:U
Last Name:APARA
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 1:3124 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2902
Mailing Address - Country:US
Mailing Address - Phone:510-531-5016
Mailing Address - Fax:510-261-6438
Practice Address - Street 1:12550 SKYLINE BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-3127
Practice Address - Country:US
Practice Address - Phone:510-531-5016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146N00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP11743FOtherSOFP
CA1689863516Medicaid
CAFHC11743FMedicaid
CAFHC11743FMedicaid
CA551876Medicare PIN