Provider Demographics
NPI:1699031179
Name:ADEJUMO, OLUWAYEMISI LOVE (MD)
Entity Type:Individual
Prefix:
First Name:OLUWAYEMISI
Middle Name:LOVE
Last Name:ADEJUMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUWAYEMISI
Other - Middle Name:LOVE
Other - Last Name:AFERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7677 OAKPORT ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1975
Mailing Address - Country:US
Mailing Address - Phone:510-437-4893
Mailing Address - Fax:510-379-7440
Practice Address - Street 1:1411 E 31ST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1018
Practice Address - Country:US
Practice Address - Phone:510-618-5768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284019207R00000X
NY284019-1207RC0000X
CAA168063207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease