Provider Demographics
NPI:1891936803
Name:AKANDE, BABATUNDE RABIU
Entity Type:Individual
Prefix:
First Name:BABATUNDE
Middle Name:RABIU
Last Name:AKANDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5730
Mailing Address - Country:US
Mailing Address - Phone:562-439-7711
Mailing Address - Fax:562-439-7715
Practice Address - Street 1:2338 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-5730
Practice Address - Country:US
Practice Address - Phone:562-439-7711
Practice Address - Fax:562-439-7715
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103725332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies