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General NPI Number Information
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NPI Number | 1902073281
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Entity Type | Organization
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Legal Business Name | ABAYOMI ADEYEMI, M.D,S.C
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 54910 APOLLO CT
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City | LA QUINTA
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State | CA
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Zip | 92253-8051
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Country | US
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Telephone | 760-222-2820
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Fax |
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Provider Business Mailing Address
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Address Line | 54910 APOLLO CT
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City | LA QUINTA
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State | CA
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Zip | 92253-8051
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Country | US
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Telephone | 760-222-2820
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. YOMI ADEYEMI
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Credential | M.D
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Telephone | 708-261-8614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036084629
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License Number State | IL
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