Healthcare Provider Details

I. General information

NPI: 1649694167
Provider Name (Legal Business Name): OLUBUKOLA OSOBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLUBUKOLA OSOBA RPH, PHD

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23801 WASHINGTON AVE
MURRIETA CA
92562-2264
US

IV. Provider business mailing address

31165 TEMECULA PKWY STE 3
TEMECULA CA
92592-2910
US

V. Phone/Fax

Practice location:
  • Phone: 951-600-8639
  • Fax: 951-304-2364
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: