Provider Demographics
NPI:1750265880
Name:ADEGBITE, MOFIYIN
Entity type:Individual
Prefix:
First Name:MOFIYIN
Middle Name:
Last Name:ADEGBITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16819 S NORMANDIE AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-6327
Mailing Address - Country:US
Mailing Address - Phone:925-428-3943
Mailing Address - Fax:925-428-3943
Practice Address - Street 1:16819 S NORMANDIE AVE APT 202
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-6327
Practice Address - Country:US
Practice Address - Phone:925-428-3943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program