Healthcare Provider Details

I. General information

NPI: 1346391620
Provider Name (Legal Business Name): ADERONKE OJO D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADERONKE OJO D.P.M

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5504 MONTEREY HWY
SAN JOSE CA
95138-1529
US

IV. Provider business mailing address

PO BOX 9425
PITTSBURG CA
94565-9425
US

V. Phone/Fax

Practice location:
  • Phone: 408-729-9700
  • Fax:
Mailing address:
  • Phone: 925-597-0936
  • Fax: 925-597-0936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: