Provider Demographics
NPI:1548004948
Name:OGUNSUYI, OSAWARU FRANK
Entity type:Individual
Prefix:
First Name:OSAWARU
Middle Name:FRANK
Last Name:OGUNSUYI
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 1:1085 SANDRINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5321
Mailing Address - Country:US
Mailing Address - Phone:916-642-7800
Mailing Address - Fax:888-870-9642
Practice Address - Street 1:1085 SANDRINGHAM WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5321
Practice Address - Country:US
Practice Address - Phone:916-642-7800
Practice Address - Fax:888-870-9642
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner