Provider Demographics
NPI:1619082773
Name:OLUSOLA O OYEKALE
Entity Type:Organization
Organization Name:OLUSOLA O OYEKALE
Other - Org Name:ES MEDICAL DISTRIBUTOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUSOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OYEKALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-971-3868
Mailing Address - Street 1:8760 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-3340
Mailing Address - Country:US
Mailing Address - Phone:323-971-3868
Mailing Address - Fax:323-971-3985
Practice Address - Street 1:8760 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-3340
Practice Address - Country:US
Practice Address - Phone:323-971-3868
Practice Address - Fax:323-971-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5682730001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5682730001Medicare NSC