Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A69105 | CA |
Y | 208600000X | Surgeon | A69105 | CA |
NPI | 1003927393 |
---|---|
Provider Name | Dr. Bolaji A Nafiu |
First Address | Murrieta, CA 92562-4900 |
Second Address | Murrieta, CA 92562-4900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I47618 | (02) | CA |