| Mogbonjubola A Adeyemo Md Professional Medical Corporation | |
|
361 N San Jacinto St Suite A B C Hemet CA 92543-3118 | |
| (951) 492-0728 | |
| Not Available |
| Full Name | Mogbonjubola A Adeyemo Md Professional Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 361 N San Jacinto St, Hemet, California |
| Authorized Official Name and Position | Marita Wagner (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9513699853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mogbonjubola A Adeyemo Md Professional Medical Corporation 361 N San Jacinto St Suite A B C Hemet CA 92543-3118 Ph: (951) 492-0728 | Mogbonjubola A Adeyemo Md Professional Medical Corporation 361 N San Jacinto St Suite A B C Hemet CA 92543-3118 Ph: (951) 492-0728 |
| NPI Number | 1770033276 |
|---|---|
| Provider Enumeration Date | 10/07/2016 |
| Last Update Date | 10/07/2016 |
| Medicare PECOS PAC ID | 0840566949 |
|---|---|
| Medicare Enrollment ID | O20171017002742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770033276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A85970 (California) | Primary |
| Provider Name | Mogbonjubola A Adeyemo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538218300 PECOS PAC ID: 8527031400 Enrollment ID: I20040818000715 |
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