Provider Demographics
NPI:1710515416
Name:OKUYEMI, FAITHFUL OLUWATONI (MD)
Entity Type:Individual
Prefix:DR
First Name:FAITHFUL
Middle Name:OLUWATONI
Last Name:OKUYEMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CITY BLVD W STE 1400
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-5900
Mailing Address - Country:US
Mailing Address - Phone:714-456-8224
Mailing Address - Fax:714-456-8360
Practice Address - Street 1:333 CITY BLVD W STE 1400
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-5900
Practice Address - Country:US
Practice Address - Phone:714-456-8224
Practice Address - Fax:714-456-8360
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program