Organization Active NPI

Olusegun Z. Salako M.D. Inc

  • Obstetrics & Gynecology Physician
  • Wilmington, CA
National Provider Identifier
1679746713
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G67118 Issued in CA
Legal business name
OLUSEGUN Z. SALAKO M.D. INC
Practice address
215 W Anaheim St
Wilmington, CA 90744-4418
Phone
(310) 816-3111
Fax
(310) 816-3116
NPI assigned
Apr 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Authorized official

Name
Dr. Thecla N. Mgbojirikwe, M.D.NPI 1710035126
Title
Pediatric Specialist/Medical Direct
Phone
(562) 218-6264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G54804 CA
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X A83572 CA
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X G67118 CA Primary

Addresses

Primary practice location

215 W Anaheim St
Wilmington, CA 90744-4418

Mailing address

215 W Anaheim St
Wilmington, CA 90744-4418
Phone (310) 816-3111

Other identifiers 2

IdentifierTypeStateIssuer
GR0098551MedicaidCA
G54804OtherCAMEDICARE SOUTHERN CA.

Other names 1

  • Comfort Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfort Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

215 W Anaheim St
Wilmington, CA 90744
Phone (714) 677-2981

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1679746713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W ANAHEIM ST",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444418",
            "telephone_number": "310-816-3111",
            "fax_number": "310-816-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W ANAHEIM ST",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444418",
            "telephone_number": "310-816-3111",
            "fax_number": "310-816-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLUSEGUN Z. SALAKO M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "MGBOJIRIKWE",
        "authorized_official_first_name": "THECLA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PEDIATRIC SPECIALIST/MEDICAL DIRECT",
        "authorized_official_telephone_number": "562-218-6264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G54804",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A83572",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G67118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098551",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SOUTHERN CA.",
            "identifier": "G54804",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.