Aiyegbusi, Modupe A.

Aiyegbusi, Modupe A. is an individual health care provider with primary practice located at 21350 Hawthorne Blvd Suite 157, Torrance CA 90503-5605. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Aiyegbusi, Modupe A. can be contacted via phone (310) 540-7240.

Contact Information

Primary practice address
21350 Hawthorne Blvd Suite 157 Torrance CA 90503-5605
Phone: (310) 540-7240
Fax: (310) 540-7280
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A65390 California

Profile Details

NPI number 1710088349
LBN Legal business name Aiyegbusi, Modupe A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Mar 23rd, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710088349 NPPES
California MEDICAID 00A653900

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