Provider Demographics
NPI:1972228021
Name:OROBIYI, ADESOJI PETER I
Entity type:Individual
Prefix:MR
First Name:ADESOJI
Middle Name:PETER
Last Name:OROBIYI
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17356 SUMMIT HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3196
Mailing Address - Country:US
Mailing Address - Phone:310-678-6147
Mailing Address - Fax:
Practice Address - Street 1:17356 SUMMIT HILLS DR
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-3196
Practice Address - Country:US
Practice Address - Phone:310-678-6147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB9244053172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver