Healthcare Provider Details

I. General information

NPI: 1972766772
Provider Name (Legal Business Name): FOLUSO N OGUNLEYE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2671
US

IV. Provider business mailing address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2671
US

V. Phone/Fax

Practice location:
  • Phone: 562-735-3226
  • Fax:
Mailing address:
  • Phone: 562-735-3226
  • Fax: 833-438-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number53728
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number159449
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number19016
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: