Provider Demographics
NPI:1619132537
Name:OGUNYEMI, OREOLUWA I (MD)
Entity Type:Individual
Prefix:
First Name:OREOLUWA
Middle Name:I
Last Name:OGUNYEMI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:6880 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4270
Mailing Address - Country:US
Mailing Address - Phone:707-823-7628
Mailing Address - Fax:707-823-1521
Practice Address - Street 1:6880 PALM AVE
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4270
Practice Address - Country:US
Practice Address - Phone:707-823-7628
Practice Address - Fax:707-823-1521
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2015-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA126139208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology