Basic Information
| Provider Information | |||||||||
| NPI: | 1881039238 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMUBIEYA | ||||||||
| FirstName: | OLAWALE | ||||||||
| MiddleName: | ODUNAYO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 757 WESTWOOD PLZ STE 7501 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900958358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8324959477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 757 WESTWOOD PLZ STE 7501 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900951736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108257375 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2013 | ||||||||
| LastUpdateDate: | 05/31/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A137077 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.