Healthcare Provider Details

I. General information

NPI: 1235882523
Provider Name (Legal Business Name): REMI AJIBOYE MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20911 EARL ST STE 300
TORRANCE CA
90503-4353
US

IV. Provider business mailing address

20911 EARL ST STE 300
TORRANCE CA
90503-4353
US

V. Phone/Fax

Practice location:
  • Phone: 310-974-4800
  • Fax:
Mailing address:
  • Phone: 310-974-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REMI M. AJIBOYE
Title or Position: CEO
Credential: MD
Phone: 310-974-4800