Healthcare Provider Details

I. General information

NPI: 1750204194
Provider Name (Legal Business Name): OLADOTUN JOSE HOSPIDALES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 S NEW HAMPSHIRE AVE # 400
LOS ANGELES CA
90005-1355
US

IV. Provider business mailing address

9774 VIA ROMA
BURBANK CA
91504-1141
US

V. Phone/Fax

Practice location:
  • Phone: 800-340-9005
  • Fax: 213-385-9246
Mailing address:
  • Phone: 818-216-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: