Basic Information
| Provider Information | |||||||||
| NPI: | 1831414770 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ONI-ORISAN | ||||||||
| FirstName: | AKINWUNMI | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ONI-ORISAN | ||||||||
| OtherFirstName: | AKIN | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1414 E MAIN ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934544890 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 N ROSE AVE STE 470 | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930307659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059882775 | ||||||||
| FaxNumber: | 8052781220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2010 | ||||||||
| LastUpdateDate: | 08/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | R1095 | TX | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | A162144 | CA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | P02311271 | 01 | CA | RAILROAD MEDICARE | OTHER | 4690816 | 01 | CA | AETNA | OTHER | 9717951 | 01 | CA | CIGNA | OTHER | CB326756 | 01 | CA | MEDICARE | OTHER |