Individual provider Active NPI

Olayiwola Martins Babalola, MD

  • Family Medicine Physician
  • San Dimas, CA
National Provider Identifier
1508548538
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20480 Issued in CA
Practice address
1350 W Covina Blvd
San Dimas, CA 91773-3245
Phone
(909) 599-6811
NPI assigned
Aug 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023027749 MO
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20480 CA Primary

Addresses

Primary practice location

1350 W Covina Blvd
San Dimas, CA 91773-3245

Mailing address

1350 W Covina Blvd
San Dimas, CA 91773-3245
Phone (909) 599-6811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725002772 NY Practitioner - Internal Medicine 3375089303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20480CAMDAddiction (Substance Use Disorder) Counselor
2023027749MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Solutions P.C. Single Specialty CurrentSince Jun 12, 2024 Accepting new patients
The Medina Clinic, Incorporated Single Specialty PastSince Aug 6, 2023 Accepting new patients

Locations

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

275 W Merrick Rd
Freeport, NY 11520
Phone (516) 377-2946

154 Prospect Ave
Plattsburgh, NY 12901
Phone (518) 563-5440

Organizations & group practices 2

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": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1508548538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W COVINA BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733245",
            "telephone_number": "909-599-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W COVINA BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733245",
            "telephone_number": "909-599-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABALOLA",
        "first_name": "OLAYIWOLA",
        "middle_name": "MARTINS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-01",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2023027749",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.