Healthcare Provider Details

I. General information

NPI: 1073231718
Provider Name (Legal Business Name): ADENIKE ALAILE OSHODI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 W MANCHESTER BLVD
INGLEWOOD CA
90305-2514
US

IV. Provider business mailing address

2220 W MANCHESTER BLVD
INGLEWOOD CA
90305-2514
US

V. Phone/Fax

Practice location:
  • Phone: 310-644-8400
  • Fax:
Mailing address:
  • Phone: 310-644-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95038806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: