Mogbonjubola a Adeyemo MD Professional Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A85970 Issued in CA

Legal business name

MOGBONJUBOLA A ADEYEMO MD PROFESSIONAL MEDICAL CORPORATION

Practice address

361 N San Jacinto St
Suite a B C
Hemet, CA 92543-3118

Phone

(951) 492-0728

NPI assigned

Oct 7, 2016

Organization subpart

No

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

Authorized official

Name

Marita Wagner

Title

Credentialing Manager

Phone

(951) 369-9853

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Mogbonjubola A Adeyemo, M.D.

  • Internal Medicine Physician
  • Hemet, CA
  • NPI 1538218300
  Medicare reassignment NPD

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1770033276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 N SAN JACINTO ST",
            "address_2": "SUITE A B C",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433118",
            "telephone_number": "951-492-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 N SAN JACINTO ST",
            "address_2": "SUITE A B C",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433118",
            "telephone_number": "951-492-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOGBONJUBOLA A ADEYEMO MD PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MARITA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "951-369-9853"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A85970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avijit Mitra, CPO
• Mjde LLC
• Carol Anne Mock, FNP-CS
• Erin Moen, PTA
• Katarina Moga
• Mohammad Abul Fielat DDS Inc
• Mohammad R. Khayali, MD a Professional Corporation
• Thomas Paul Mohr, M.D.
• Tamanna Vinodkumar Mohta
• Yvonne Michelle Moimoi, CAARR

• Internal Medicine Physician in Hemet, CA
• Providers in Hemet, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.