Individual provider Active NPI

Ibukun Olaitan Akinsola, FNP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1396592564
Registry record updated Sep 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030041 Issued in CA
Practice address
200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone
(909) 409-4536
NPI assigned
May 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030041 CA Primary

Addresses

Primary practice location

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Mailing address

6597 Sonoma Ave
Fontana, CA 92336-3203
Phone (909) 733-9306

Other practice location 1

5015 Eagle Rock Blvd
Los Angeles, CA 90041-2085
Phone (747) 300-7541

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
I20240910002499 CA Practitioner - Nurse Practitioner 3577003169 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Care CurrentSince Oct 4, 2024 Accepting new patients
Albion Medical Partners of California West P C CurrentSince Dec 12, 2025 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Molina Healthcare of California CurrentSince Sep 23, 2024 Accepting new patients
Legacy Marketing Worldwide Inc. CurrentSince Feb 1, 2026 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

5015 Eagle Rock Blvd
Ste 200
Los Angeles, CA 90041
Phone (323) 455-4868

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727568000000",
    "number": "1396592564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6597 SONOMA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363203",
            "telephone_number": "909-733-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "909-409-4536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5015 Eagle Rock Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900412085",
            "country_code": "US",
            "telephone_number": "747-300-7541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKINSOLA",
        "first_name": "IBUKUN",
        "middle_name": "OLAITAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.