MEDICARE: IYOBOSA FAVOR ERHABOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	27545	CA

General Provider Information

NPI Number	:	1427903418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IYOBOSA FAVOR ERHABOR

Provider Business Mailing Address
First Line	:	8554 BURNET AVE UNIT 101
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-6725
Country	:	US
Telephone Number	:	818-987-3946
Fax Number	:

Provider Business Practice Location Address
First Line	:	8554 BURNET AVE UNIT 101
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-6725
Country	:	US
Telephone Number	:	818-987-3946
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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