NPIMap

Individual provider Active NPI

Omolade Ogun, MD

  • Family Medicine Physician
  • Marina del Rey, CA
National Provider Identifier
1548526494
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A121040 Issued in CA
Practice address
4676 Admiralty Way FL 4
Marina del Rey, CA 90292-6601
Phone
(310) 306-6966
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A121040 CA Primary

Addresses

Primary practice location

4676 Admiralty Way FL 4
Marina del Rey, CA 90292-6601

Mailing address

PO Box 20471
Bakersfield, CA 93390-0471
Phone (310) 465-8448

Other practice location 1

3501 Stockdale Avenue,
Bakersfield, CA 93309
Phone (310) 465-8448

Other names 1

  • Dr. Omolade Akinsanya Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150217001933 CA Practitioner - Family Practice 9638494503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4676 Admiralty Way
FL 4
Marina del Rey, CA 90292-6601
Phone (310) 423-4933

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121040CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Oct 11, 2021 Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Sep 29, 2019 Accepting new patients
Clinicas de Salud del Pueblo, Inc. CurrentSince Sep 29, 2019 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Oct 11, 2021 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients

Locations

321 W Hobsonway
Ste C
Blythe, CA 92225
Phone (760) 922-4981

1166 K St
Brawley, CA 92227
Phone (760) 344-3583

223 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-2020

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4676 Admiralty Way
Fl 4
Marina del Rey, CA 90292
Phone (310) 306-6966

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: oogun239233@direct.cshs.org

Organizations & group practices 6

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1548526494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20471",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933900471",
            "telephone_number": "310-465-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4676 ADMIRALTY WAY FL 4",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926601",
            "telephone_number": "310-306-6966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Stockdale Avenue,",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "93309",
            "country_code": "US",
            "telephone_number": "310-465-8448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUN",
        "first_name": "OMOLADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A121040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OMOLADE",
            "last_name": "AKINSANYA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.