Healthcare Provider Details

I. General information

NPI: 1356515654
Provider Name (Legal Business Name): FOLUKE ADEOLA AKINYEMI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92350-1716
US

IV. Provider business mailing address

11234 ANDERSON STREET GME OFFICE UA-202
LOMA LINDA CA
92350-1716
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4918
  • Fax:
Mailing address:
  • Phone: 909-558-4918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberQ1345
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License NumberQ1345
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA109404
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA109404
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: