Provider Information for 1609330778
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ADEKUNLE OLUREMI ILORI
Sex: Male
NPI: 1609330778
Last Updated: 2024-09-17
Certification Date: 2024-09-17
Certification Date: 2024-09-17
Details
Name | Value | ||||||||||||||||
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NPI | 1609330778 | ||||||||||||||||
Enumeration Date | 2019-01-23 | ||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||
Sole Proprietor | NO | ||||||||||||||||
Status | Active | ||||||||||||||||
Mailing Address | 21101 DALE EVANS PKWY APPLE VALLEY, CA 92307-9356 United States Phone: 760-961-6720 | Fax: | ||||||||||||||||
Primary Practice Address | 850 E FOOTHILL BLVD RIALTO, CA 92376-5230 United States Phone: 909-421-9233 | Fax: | ||||||||||||||||
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