Provider Demographics
NPI:1922001429
Name:SHITTU, ADEKUNLE NURUDEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEKUNLE
Middle Name:NURUDEEN
Last Name:SHITTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 CAMINO MEDIA
Mailing Address - Street 2:APT 100
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2026
Mailing Address - Country:US
Mailing Address - Phone:661-665-8147
Mailing Address - Fax:
Practice Address - Street 1:2101 7TH ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-1502
Practice Address - Country:US
Practice Address - Phone:661-758-2263
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH89920Medicare UPIN