Provider Demographics
NPI:1942496096
Name:OLUBI, OLUYEMISI ADERONKE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:OLUYEMISI
Middle Name:ADERONKE
Last Name:OLUBI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:OLUYEMISI
Other - Middle Name:ADERONKE
Other - Last Name:AKINHANMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11725 CLEMATIS DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-8494
Mailing Address - Country:US
Mailing Address - Phone:612-306-7858
Mailing Address - Fax:
Practice Address - Street 1:11725 CLEMATIS DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-8494
Practice Address - Country:US
Practice Address - Phone:951-638-1315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-22
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ410442083P0500X, 2083X0100X, 208D00000X
MN197882083P0500X
CAC1446892083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ9088408OtherAETNA
AZ461441Medicaid
AZ9088408OtherAETNA