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General NPI Number Information
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NPI Number | 1376552141
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Entity Type | Individual
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Provider Name | BOLANLE ABIMBOLA OLAJIDE MD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 433 N 4TH ST STE 205A
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City | MONTEBELLO
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State | CA
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Zip | 90640-4311
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Country | US
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Telephone | 323-920-0505
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Fax |
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Provider Business Mailing Address
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Address Line | 433 N 4TH ST STE 205A
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City | MONTEBELLO
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State | CA
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Zip | 90640-4311
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Country | US
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Telephone | 323-920-0505
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A69322
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License Number State | CA
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