Individual provider Active NPI

Olakunle Wasiu Akande, PHYSICAL THERAPIST

  • Physical Therapist
  • Rancho Cucamonga, CA
National Provider Identifier
1104035559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27702 Issued in CA
Practice address
12973 Riley CT
Rancho Cucamonga, CA 91739-8850
Phone
(562) 964-1255
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27702 CA Primary

Addresses

Primary practice location

12973 Riley CT
Rancho Cucamonga, CA 91739-8850

Mailing address

12973 Riley CT
Rancho Cucamonga, CA 91739-8850
Phone (562) 964-1255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104035559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12973 RILEY CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917398850",
            "telephone_number": "562-964-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12973 RILEY CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917398850",
            "telephone_number": "562-964-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKANDE",
        "first_name": "OLAKUNLE",
        "middle_name": "WASIU",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "27702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.