Provider Demographics
NPI:1306124862
Name:ADESANYA, DAVID OLUFEMI (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:OLUFEMI
Last Name:ADESANYA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 SILVERADO ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-3202
Mailing Address - Country:US
Mailing Address - Phone:951-454-1310
Mailing Address - Fax:
Practice Address - Street 1:2152 SILVERADO ST
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-3202
Practice Address - Country:US
Practice Address - Phone:951-454-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health