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General NPI Number Information
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NPI Number | 1689754665
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Entity Type | Individual
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Provider Name | SARAH SAM OLELEWE M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 11712 HAWTHORNE BLVD
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City | HAWTHORNE
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State | CA
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Zip | 90250
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Country | US
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Telephone | 310-679-9293
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Fax | 310-715-8686
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Provider Business Mailing Address
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Address Line | PO BOX 238
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City | AGOURA HILLS
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State | CA
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Zip | 91376-0238
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Country | US
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Telephone | 310-679-9293
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Fax | 310-679-4017
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A56520
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License Number State | CA
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