Elizabeth Anne Awodele, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A16090 Issued in CA

Practice address

6540 Lusk Blvd
San Diego, CA 92121-2767

Phone

(619) 940-6269

NPI assigned

Jun 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth O'Keefe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1396183281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD STE 261",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212767",
            "telephone_number": "619-940-6269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92134",
            "country_code": "US",
            "telephone_number": "619-532-5733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWODELE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2021-08-18",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2013017844",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A16090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "O'KEEFE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda Awdishu, BSCPHM
• Marta Awdykovych, M.D.
• Alina Chung Aweau, LMFT
• Nasiim Abdurahman Aweis
• Awesome Healing Acupuncture
• Terr Awoko
• Adenike Awolola, NP
• Isaac Awolola, DNP, FNP-BC, ENP-C
• Alexandra Awrahem, PHARMD
• Joyce Lynn Awramik, D.D.S.

• Physical Medicine & Rehabilitation Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.