Individual provider Active NPI

Isaac Awolola, DNP, FNP-BC, ENP-C

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1083599229
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95035472 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(619) 543-2091
NPI assigned
Aug 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95035472 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

200 W Arbor Dr
San Diego, CA 92103-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604004334 CA Order and Referring Only - Nurse Practitioner 8022509678

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95035472CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1083599229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWOLOLA",
        "first_name": "ISAAC",
        "credential": "DNP, FNP-BC, ENP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95035472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.