NPIMap

Individual provider Active NPI

Olukemi A Wallace, M.D.

  • Specialist
  • Inglewood, CA
National Provider Identifier
1609804350
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A48240 Issued in CA
Practice address
2220 W Manchester Blvd
Inglewood, CA 90305-2514
Phone
(310) 644-8400
Fax
(310) 644-8424
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A48240 CA Primary

Addresses

Primary practice location

2220 W Manchester Blvd
Inglewood, CA 90305-2514

Mailing address

15342 Hawthorne Blvd
Suite 102
Lawndale, CA 90260-2152
Phone (310) 644-8400

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
I20040521001295 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7012803562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oncology Institute Ca, a Professional CorporationGroup PAC ID 5698872398, 114 clinicians
Uptimum Medical Group and Ipa IncGroup PAC ID 4183993637, 4 clinicians

Practice addresses (Care Compare)

1127 Wilshire Blvd
Suite 900
Los Angeles, CA 90017-3910
Phone (213) 481-3948

11525 Brookshire Ave
Suite 202
Downey, CA 90241-4983
Phone (562) 869-1201

13768 Roswell Ave
Suite 105
Chino, CA 91710-1401
Phone (909) 591-0814

1513 S Grand Ave
Suite 360
Los Angeles, CA 90015-3465
Phone (213) 246-2422

2220 W Manchester Blvd
Inglewood, CA 90305-2514
Phone (310) 644-8400

3300 E S St
Suite 304
Lakewood, CA 90805-4594
Phone (562) 232-0550

399 E Highland Ave
Suite 501
San Bernardino, CA 92404-3879
Phone (909) 982-4252

900 S Main St
Suite 204
Corona, CA 92882-3401
Phone (951) 372-2400

Hospital & facility affiliations

  • Olive Home Health Center, Inc Home health agency, Inglewood, CA, CCN 059646
  • Destiny Home Health Services, Inc Home health agency, Torrance, CA, CCN 059629
  • Impact Home Health Care, Inc. Home health agency, Encino, CA, CCN 757514
  • Memorial Hospital of Gardena Hospital, Gardena, CA, CCN 050468
  • Coast Plaza Hospital Hospital, Norwalk, CA, CCN 050771
  • East Los Angeles Doctors Hospital Hospital, Los Angeles, CA, CCN 050641
  • Community Hospital of Huntington Park Hospital, Huntington Park, CA, CCN 050091
  • Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779
  • Vermont Healthcare Center Nursing home, Torrance, CA, CCN 056433

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Manchester Community Medical Center Internal Medicine Current Accepting new patients
The Oncology Institute Ca, a Professional Corporation CurrentSince Feb 27, 2023 Accepting new patients
Starling Oncology Ca, a Professional Corporation CurrentSince Feb 27, 2023 Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
Little Company of Mary Affiliated Services Inc Internal Medicine Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Uptimum Medical Group and Ipa Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Gardena Hospital LP Past Accepting new patients
St. Francis Medical Center Past Accepting new patients
County of Los Angeles Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Uptimum Care Medical Group &Ipa Inc Past Accepting new patients
Saint Francis Medical Center Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

18000 Studebaker Rd
Ste 800
Cerritos, CA 90703

900 S Main St
Ste 204
Corona, CA 92882
Phone (951) 372-2400

11525 Brookshire Ave
Ste 202
Downey, CA 90241
Phone (562) 242-2070

11525 Brookshire Ave
Downey, CA 90241
Phone (562) 861-0954

11480 Brookshire Ave
Ste 309
Downey, CA 90241
Phone (562) 869-1201

11100 Warner Ave
Ste 214
Fountain Vly, CA 92708
Phone (714) 594-7820

6121 N Thesta St
Ste 204
Fresno, CA 93710
Phone (559) 438-7390

2220 W Manchester Blvd
Inglewood, CA 90305
Phone (310) 644-8400

3300 E South St
Ste 304
Lakewood, CA 90805
Phone (562) 232-0550

399 E Highland Ave
Ste 501
Sn Bernrdno, CA 92404
Phone (909) 982-4252

425 Haaland Dr
Ste 103
Thousand Oaks, CA 91361
Phone (805) 345-2020

2067 W Vista Way
Ste 295
Vista, CA 92083
Phone (526) 735-3226

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: olukemi.wallace@theoncologyinstitute.ikm.direct-ci.com
  • Direct secure messaging: owallace@uptimum.curemd.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 12

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1609804350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15342 HAWTHORNE BLVD",
            "address_2": "SUITE 102",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602152",
            "telephone_number": "310-644-8400",
            "fax_number": "310-644-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 W MANCHESTER BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052514",
            "telephone_number": "310-644-8400",
            "fax_number": "310-644-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "OLUKEMI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A48240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.