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NPI Code Detail

MEDICARE: OLADAYO BALOGUN

MEDICARE: OLADAYO BALOGUN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1780534446
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLADAYO BALOGUN
Provider Business Mailing Address
First Line : 12459 LEWIS ST STE 201
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-6606
Country : US
Telephone Number : 800-249-1266
Fax Number :
Provider Business Practice Location Address
First Line : 12459 LEWIS ST STE 201
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-6606
Country : US
Telephone Number : 800-249-1266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ OLADAYO BALOGUN ” Practice Location

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