| Sarah S Olelewe, Md, Inc | |
|
11712 Hawthorne Blvd Hawthorne CA 90250-2324 | |
| (310) 679-9293 | |
| (310) 715-8686 |
| Full Name | Sarah S Olelewe, Md, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11712 Hawthorne Blvd, Hawthorne, California |
| Authorized Official Name and Position | Sarah Sam Olelewe (CEO) |
| Authorized Official Contact | 3106799293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sarah S Olelewe, Md, Inc Po Box 238 Agoura Hills CA 91376-0238 Ph: (310) 679-9293 | Sarah S Olelewe, Md, Inc 11712 Hawthorne Blvd Hawthorne CA 90250-2324 Ph: (310) 679-9293 |
| NPI Number | 1386724383 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 08/30/2018 |
| Medicare PECOS PAC ID | 4082800321 |
|---|---|
| Medicare Enrollment ID | O20101129000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386724383 | NPI | - | NPPES |
| 00A565200 | Other | CA | BLUE SHIELD PROV NUMBER |
| 00A565201 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | A56520 (California) | Primary |
| Provider Name | Sarah Sam Olelewe |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1689754665 PECOS PAC ID: 7517153851 Enrollment ID: I20101129000205 |
| Provider Name | Ogbonna Iwuamadi Olelewe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043751886 PECOS PAC ID: 4284908906 Enrollment ID: I20170919003785 |
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