{
"Npi": {
"NPI": "1942496096",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OLUBI",
"FirstName": "OLUYEMISI",
"MiddleName": "ADERONKE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD, MPH.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "AKINHANMI",
"OtherFirstName": "OLUYEMISI",
"OtherMiddleName": "ADERONKE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "MD.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "11762 DE PALMA RD",
"SecondLineMailingAddress": "STE 1C #507",
"MailingAddressCityName": "CORONA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92883-8494",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-306-7858",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "760 S WASHBURN AVE",
"SecondLinePracticeLocationAddress": "STE 22",
"PracticeLocationAddressCityName": "CORONA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92882",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-638-1315",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/22/2007",
"LastUpdateDate": "06/16/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2083P0500X",
"TaxonomyName": "Preventive Medicine/Occupational Environmental Medicine Physician",
"LicenseNumber": "41044",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2083P0500X",
"TaxonomyName": "Preventive Medicine/Occupational Environmental Medicine Physician",
"LicenseNumber": "19788",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2083X0100X",
"TaxonomyName": "Occupational Medicine Physician",
"LicenseNumber": "41044",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "41044",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2083X0100X",
"TaxonomyName": "Occupational Medicine Physician",
"LicenseNumber": "C144689",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}