Healthcare Provider Details

I. General information

NPI: 1336259118
Provider Name (Legal Business Name): CARE PLUS MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 W TEMPLE ST
LOS ANGELES CA
90026-5421
US

IV. Provider business mailing address

1711 W TEMPLE ST STE 3036
LOS ANGELES CA
90026-7335
US

V. Phone/Fax

Practice location:
  • Phone: 213-989-6160
  • Fax:
Mailing address:
  • Phone: 818-997-7117
  • Fax: 818-997-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ADEBAMBO OSIBAMIRO-SEDUN
Title or Position: PRESIDENT
Credential: MD
Phone: 818-997-7117