Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 20459 | CA |
NPI | 1558573220 |
---|---|
Provider Name | Dr. Gbolahan A Olajide |
First Address | Corona, CA 92882-3421 |
Second Address | Corona, CA 92882-3421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |