MR. BABAJIDE ADETOKUNBO FAJEMISIN (NPI# 1700119567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700119567 |
| Entity Type | Individual |
| Full Name | MR. BABAJIDE ADETOKUNBO FAJEMISIN |
| Credential | PA-C |
| Practice Address |
15791 Bear Valley Rd Hesperia CA 92345-1746 |
| Mailing Address |
625 Fair Oaks Ave Ste 270 South Pasadena CA 91030-5801 |
| Practice Telephone | 7609491231 |
| Practice Fax Number | 8777383841 |
| Mailing Telephone | 6263462455 |
| Mailing Fax Number | 6266393005 |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2020-02-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363A00000X | Physician Assistant | PA20295 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | EFF: 1/18/2013 | 05 | |
| CA | EFF.10/21/13-COLTON | 05 | |
| CA | EFF:10/21/13-VICTORV | 05 | |
| CA | EFF: 1/18/13 | 05 | |
| CA | EFF: 1/24/2013 | 05 | |
| CA | EFF:10/29/12 | 05 | |
| CA | RAILROAD MEDICARE-ADELANTO | P01282519/DU4034 | 01 |
| CA | RAILROAD MEDICARE-COLTON/VICTORVILLE | P01288530/DU5182 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7261 Plum Tree Pl, Fontana, CA 923365719 | 3109361068 |
| Street Address |
15791 BEAR VALLEY RD |
| City | HESPERIA |
| State | CA |
| Zip Code | 92345-1746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346250396 | Dr.mikel Walk In Clinic Inc | Family Medicine | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2006-08-09 |
| 1730788977 | Rebecca Sue Alfonzo | Nurse Practitioner | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2020-10-20 |
| 1114421211 | Halima Zainab | Nurse Practitioner | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2018-03-22 |
| 1912367640 | Virginia Moore | Physician Assistant | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2016-02-23 |
| 1326356601 | Trent Tyson Davis | Physician Assistant | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2010-09-20 |
| 1972658151 | Vista Pharmacies, Inc. | Pharmacy | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2007-01-25 |
| 1881762433 | Laverne Christie | Physician Assistant | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881467 | Leslie Guzman | Behavioral Analyst | 6700 Newhall Ave, Hesperia, CA 92345 | 2020-08-14 |
| 1134769896 | Nu Wave Medical Group Inc | Family Medicine | 9390 Hesperia Rd Suite 7, Hesperia, CA 92345 | 2020-01-10 |
| 1760901383 | Lindsey Kathleen Dunnagan | Counselor | 16501 Walnut Street, Suite 12, Hesperia, CA 92345 | 2017-09-14 |
| 1356869374 | Deborah Irene Freeman | Nurse Practitioner | 15398 Main Street Suite A, Hesperia, CA 92345 | 2017-08-30 |
| 1902260151 | Serge Bronstein | Counselor | 16808 Main St., D-154, Hesperia, CA 92345 | 2016-04-13 |
| 1366815805 | Caremore Health Plan | Nurse Practitioner | 17085 Main Street, Hesperia, CA 92345 | 2015-11-05 |
| 1174928402 | Jennifer Cathrin Bayle | Counselor | 17130 Sequoia St, Suite 106, Hesperia, CA 92345 | 2014-10-29 |
| 1447654256 | Diana Grace Chilstrom | Marriage & Family Therapist | 11776 Mariposa Road, Hesperia, CA 92345 | 2014-10-22 |
| 1639597545 | Adrianna Ebony Williams | Physical Therapy Assistant | 8939 11th Ave, Hesperia, CA 92345 | 2014-03-29 |
| 1477974426 | Aja Stoll | Case Manager/Care Coordinator | 9655 Ninth Ave, Hesperia, CA 92345 | 2013-12-18 |
| Find all providers in zip 92345 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609402114 | Vanessa Franco | Physician Assistant | 8866 Palo Alto Ave, Hesperia, CA 92344-5526 | 2020-03-16 |
| 1669833562 | Assess Medical Group, Inc. | Physician Assistant | 10752 Oakwood Ave, Hesperia, CA 92345-2452 | 2016-03-19 |
| 1457532681 | Toni Fernandez | Physician Assistant | 15888 Main St Ste 112b, Hesperia, CA 92345-3467 | 2007-11-15 |
| 1063613958 | Keli Layton-cunnigan | Physician Assistant | 17043 Main St, Hesperia, CA 92345-6055 | 2007-05-30 |
| 1013001213 | Kevin Wing Yim | Physician Assistant | 16455 Main St., Hesperia, CA 92345-3500 | 2006-10-03 |
| 1992210660 | Alice Wang | Physician Assistant | 17095 Main St, Hesperia, CA 92345-6004 | 2017-12-04 |
| 1912367640 | Virginia Moore | Physician Assistant | 15791 Bear Valley Rd, Hesperia, CA 92345-1746 | 2016-02-23 |
| 1679908552 | Angela Michelle Hannah | Physician Assistant | 78 N Division St, Hesperia, MI 49421-5100 | 2013-09-10 |
| 1558632471 | Mayra Velazquez | Physician Assistant | 11919 Hesperia Rd, Hesperia, CA 92345-2158 | 2012-01-24 |
| 1881883064 | Angela Kwafoa Mimi Amoani | Physician Assistant | 17095 Main St, Hesperia, CA 92345-6004 | 2007-10-23 |
| Find all providers in HESPERIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.