Provider Demographics
NPI:1720821267
Name:TOBALESI, OPEYEMI PAUL (MD)
Entity type:Individual
Prefix:MR
First Name:OPEYEMI
Middle Name:PAUL
Last Name:TOBALESI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 COLBY AVENUE #B3-039 WSU INTERNAL MEDICINE RESIDEN
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1665
Mailing Address - Country:US
Mailing Address - Phone:425-297-5234
Mailing Address - Fax:
Practice Address - Street 1:1321 COLBY AVENUE #B3-039 WSU INTERNAL MEDICINE RESIDEN
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1665
Practice Address - Country:US
Practice Address - Phone:425-297-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2025-01-31
Deactivation Date:2025-01-17
Deactivation Code:
Reactivation Date:2025-01-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program