| Doctor Name: | OMONIYI TEMITOPE AKINTOLA |
| NPI Number: | 1548443328 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA C |
| License Number: | PA16410 |
| Business Practice Address: | 4001 Hwy 104 Ione, CA - 95640 |
| Business Phone Number: | 2092744911 |
| Business Fax Number: | |
| Mailing Address: | 6330 Laguna Villa Way, ELK GROVE |
| State: | CA |
| Postal Code: | 957584735 |
| Phone Number: | 9165499029 |
| Fax Number: | |
| NPI Enumeration Date: | 12/14/2007 |
| NPI Last Update Date: | 12/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA16410 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |