Provider Demographics
NPI:1316112725
Name:OBILEYE, HELEN ABIOLA
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ABIOLA
Last Name:OBILEYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 MAIN ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-3453
Mailing Address - Country:US
Mailing Address - Phone:760-956-9100
Mailing Address - Fax:760-956-4888
Practice Address - Street 1:15800 MAIN ST
Practice Address - Street 2:SUITE 270
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3453
Practice Address - Country:US
Practice Address - Phone:760-956-9100
Practice Address - Fax:760-956-4888
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47757332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6070530001Medicare NSC