Basic Information
| Provider Information | |||||||||
| NPI: | 1306823166 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OTULANA | ||||||||
| FirstName: | BABATUNDE | ||||||||
| MiddleName: | ADEKUNLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 441 COVENTRY PL | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945061257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256487673 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4150 V ST | ||||||||
| Address2: | SUITE 3400 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167343564 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207PT0002X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Emergency Medicine | Medical Toxicology | 207R00000X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RI0200X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RP1001X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 208M00000X | C51121 | CA | X | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.