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General NPI Number Information
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NPI Number | 1316027360
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Entity Type | Individual
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Provider Name | ANTHONY OGUNDIPE
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 3628 E IMPERIAL HWY STE 200
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City | LYNWOOD
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State | CA
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Zip | 90262-2646
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Country | US
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Telephone | 310-603-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 3628 E IMPERIAL HWY STE 200
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City | LYNWOOD
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State | CA
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Zip | 90262-2646
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | G64561
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License Number State | CA
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