| Dr Omotayo O Alamutu, DNP, FNP, PMHNP | |
|
103 Bodin Cir, Travis Afb, CA 94535-1801 | |
| (707) 908-5630 | |
| Not Available |
| Full Name | Dr Omotayo O Alamutu |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 103 Bodin Cir, Travis Afb, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689978652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 19624 (California) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 19624 (California) | Primary |
| Entity Name | Mellow Medical Inc a Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407275886 PECOS PAC ID: 3375767403 Enrollment ID: O20140611002222 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Omotayo O Alamutu, DNP, FNP, PMHNP 12301 Wilshire Blvd Ste 512, Los Angeles, CA 90025-1053 Ph: Not Available | Dr Omotayo O Alamutu, DNP, FNP, PMHNP 103 Bodin Cir, Travis Afb, CA 94535-1801 Ph: (707) 908-5630 |
Ms. Kara N Granroth, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3400 |
Dr. Cenean Walls Raphemot, FPMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-5174 |
Yardana Gill, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir Bldg 777, Travis Afb, CA 94535 Phone: 707-423-2300 Fax: 707-423-3357 |
Joshua Mark Blanchard, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3653 |
Mrs. Nicole Ivy-kutzler, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-816-7894 |
Leslie A Christopher, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Circle, Travis Afb, CA 94535 Phone: 707-423-5311 |
Miss Roshani Subedi, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-5447 |