=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902257744
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OLUREMILEKUN DAODU R.N.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2016
-----------------------------------------------------
Last Update Date | 06/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 814 14TH ST
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94607-3247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-878-7951
-----------------------------------------------------
Fax | 510-560-2447
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2450 WASHINGTON AVE STE 150
-----------------------------------------------------
City | SAN LEANDRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94577-5979
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-878-7951
-----------------------------------------------------
Fax | 510-560-2447
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VISITING NURSE
-----------------------------------------------------
Name | OLUREMILEKUN DAODU
-----------------------------------------------------
Credential | REGISTERED NURSE
-----------------------------------------------------
Telephone | 510-878-7951
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 497193
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------