Provider Demographics
NPI:1346391620
Name:OJO, ADERONKE (DPM)
Entity type:Individual
Prefix:DR
First Name:ADERONKE
Middle Name:
Last Name:OJO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ADERONKE
Other - Middle Name:
Other - Last Name:OJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:PO BOX 9425
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-9425
Mailing Address - Country:US
Mailing Address - Phone:925-597-0936
Mailing Address - Fax:925-597-0936
Practice Address - Street 1:5504 MONTEREY HWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1529
Practice Address - Country:US
Practice Address - Phone:408-729-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4601213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E46010Medicare PIN