Organization Active NPI

Ade Osibamiro MD Inc

Doing business as Santa Fe Medical Clinic

  • General Practice Physician
  • Carson, CA
National Provider Identifier
1073547220
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A64972 Issued in CA
Legal business name
ADE OSIBAMIRO MD INC
Doing business as
Santa Fe Medical Clinic
Practice address
2637 E Carson St
Carson, CA 90810-1508
Phone
(310) 847-1321
NPI assigned
Jul 11, 2006
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Thomas Petit, MDNPI 1134423387
Title
Director
Phone
(310) 847-1321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A64972 CA Primary

Addresses

Primary practice location

2637 E Carson St
Carson, CA 90810-1508

Mailing address

2637 E Carson St
Carson, CA 90810-1508
Phone (310) 847-1321

Other identifiers 1

IdentifierTypeStateIssuer
C196078MedicaidCA

Other names 1

  • SANTA FE MEDICAL CLINIC Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2065992Santa Fe Medical Clinic2637 E Carson Street, Carson, CA 90810Certificate of waiverSep 17, 2027

National Provider Directory

National Provider Directory

Locations

2637 E Carson St
Carson, CA 90810
Phone (310) 847-1321

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1073547220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 E CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "908101508",
            "telephone_number": "310-847-1321",
            "fax_number": "310-847-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 E CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "908101508",
            "telephone_number": "310-847-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADE OSIBAMIRO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "PETIT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-847-1321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A64972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C196078",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SANTA FE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.