Provider Demographics
NPI:1285083907
Name:OYEYIPO, OYEKUNLE (CQT)
Entity type:Individual
Prefix:
First Name:OYEKUNLE
Middle Name:
Last Name:OYEYIPO
Suffix:
Gender:M
Credentials:CQT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 ORIZABA AVE
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-1201
Mailing Address - Country:US
Mailing Address - Phone:626-692-5597
Mailing Address - Fax:
Practice Address - Street 1:646 W PACIFIC COAST HWY STE 4
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5239
Practice Address - Country:US
Practice Address - Phone:626-692-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24372247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other