Individual provider · NPI-1

Dr. Modupe A. Aiyegbusi, M.D.

Family Medicine · Torrance, CA

NPI number1710088349
StatusActive
Last updated in NPPESMar 23, 2017

Details

NPI
1710088349
Entity type
Individual (NPI-1)
Name
Dr. Modupe A. Aiyegbusi
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Sep 26, 2006
Last updated
Mar 23, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineA65390CAYes

Practice location

21350 Hawthorne Blvd
Suite 157
Torrance, CA 90503-5605

Phone 310-540-7240 · Fax 310-540-7280

Mailing address

3661 Torrance Blvd
Ste 103
Torrance, CA 90503-4887

Phone 310-540-7240 · Fax 310-540-7280

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