Provider Demographics
NPI:1376121418
Name:SODEKE, PATRICK OLUMUYIWA (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:OLUMUYIWA
Last Name:SODEKE
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 1:11039 N VIA ARGENTA WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-7067
Mailing Address - Country:US
Mailing Address - Phone:423-557-9623
Mailing Address - Fax:
Practice Address - Street 1:4785 N FIRST ST
Practice Address - Street 2:KAISER PERMANENTE FIRST STREET MEDICAL OFFICE
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726
Practice Address - Country:US
Practice Address - Phone:559-448-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA193561208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics