Provider Demographics
NPI:1881882256
Name:JOHNSON, OLUWATUMININU AYOTOKUNBO (MD)
Entity type:Individual
Prefix:DR
First Name:OLUWATUMININU
Middle Name:AYOTOKUNBO
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2323 KNOLL DR STE 219
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7307
Mailing Address - Country:US
Mailing Address - Phone:805-677-5312
Mailing Address - Fax:805-677-5304
Practice Address - Street 1:1334 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2926
Practice Address - Country:US
Practice Address - Phone:805-933-1122
Practice Address - Fax:805-933-0522
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA128874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine