Individual provider Active NPI

Oluseyi Ayoola Obadeyi

  • Interventional Pain Medicine Physician
  • Fullerton, CA
National Provider Identifier
1972182459
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A191388 Issued in CA
Practice address
100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone
(714) 446-5200
NPI assigned
Apr 3, 2021
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A191388 CA
Interventional Pain Medicine Physician 208VP0014X A191388 CA Primary

Addresses

Primary practice location

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800

Mailing address

2212 E 4TH St Ste 103
Santa Ana, CA 92705-3871
Phone (714) 571-7779

Other practice location 1

100 N State College Blvd Ste H
Fullerton, CA 92831-4236
Phone (714) 824-6565

Other practice location 2

11100 Warner Ave Ste 310
Fountain Valley, CA 92708-4009
Phone (714) 824-6560

Other practice location 3

11234 Anderson St
Loma Linda, CA 92350-1716
Phone (909) 558-4085

Other practice location 4

2212 E 4th St Ste 103
Santa Ana, CA 92705-3871
Phone (714) 571-7779

Other practice location 5

10565 Civic Center Dr Bldg Ste 165
Rancho Cucamonga, CA 91730-3853
Phone (909) 985-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240819003004 CA Practitioner - Pain ManagementPractitioner - Emergency Medicine 4688112832 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Emergency Medicine
Education
Wayne State University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Algos Inc a Medical CorporationGroup PAC ID 8123917713, 24 clinicians

Practice addresses (Care Compare)

10565 Civic CNTR Dr W BLDG
Suite 165
Rancho Cucamonga, CA 91730-3734
Phone (909) 985-2211

11370 Anderson St
Loma Linda, CA 92354-3450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A191388CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Algos Inc., a Medical Corporation CurrentSince May 1, 2025 Accepting new patients
Algos Inc., a Medical Corporation Pain Medicine CurrentSince May 1, 2025 Accepting new patients
Algos Inc., a Medical Corporation Pain Medicine Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2024 Accepting new patients
Algos Inc., a Medical Corporation Pain Medicine Past Accepting new patients

Locations

13193 Central Ave
Chino, CA 91710
Phone (909) 464-9675

13193 Central Ave
Ste 220
Chino, CA 91710
Phone (909) 591-0843

11100 Warner Ave
Ste 310
Fountain Vly, CA 92708
Phone (714) 424-0109

100 N State College Blvd
Ste H
Fullerton, CA 92831
Phone (714) 824-6565

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
Ofc
Loma Linda, CA 92350
Phone (909) 558-4074

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

10565 Civic Center Dr
Rancho Cucamonga, CA 91730
Phone (909) 527-3585

10565 Civic Center Dr
Ste 250
Rancho Cucamonga, CA 91730
Phone (909) 493-3800

69780 Stellar Dr
#A
Rancho Mirage, CA 92270
Phone (760) 424-3380

10565 Civic Center Dr
Ste 165
Rch Cucamonga, CA 91730
Phone (888) 824-2144

1125 E 17th St
Ste N452
Santa Ana, CA 92701
Phone (714) 597-7214

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 1

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1972182459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 103",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053871",
            "telephone_number": "714-571-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR STE 310",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353800",
            "telephone_number": "714-446-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N State College Blvd Ste H",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928314236",
            "country_code": "US",
            "telephone_number": "714-824-6565",
            "fax_number": "714-930-7926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11100 Warner Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927084009",
            "country_code": "US",
            "telephone_number": "714-824-6560",
            "fax_number": "714-475-2154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923501716",
            "country_code": "US",
            "telephone_number": "909-558-4085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2212 E 4th St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053871",
            "country_code": "US",
            "telephone_number": "714-571-7779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10565 Civic Center Dr Bldg Ste 165",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303853",
            "country_code": "US",
            "telephone_number": "909-985-2211",
            "fax_number": "909-985-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBADEYI",
        "first_name": "OLUSEYI",
        "middle_name": "AYOOLA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A191388",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A191388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.