MEDICARE: BABATUNDE RABIU AKANDE

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	103725	CA

General Provider Information

NPI Number	:	1891936803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BABATUNDE RABIU AKANDE

Provider Business Mailing Address
First Line	:	2338 E ANAHEIM ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-5730
Country	:	US
Telephone Number	:	562-439-7711
Fax Number	:	562-439-7715

Provider Business Practice Location Address
First Line	:	2338 E ANAHEIM ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-5730
Country	:	US
Telephone Number	:	562-439-7711
Fax Number	:	562-439-7715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	03/20/2009

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