Provider Demographics
NPI:1265594519
Name:BABARINDE, TINUOLA K (MD)
Entity type:Individual
Prefix:MRS
First Name:TINUOLA
Middle Name:K
Last Name:BABARINDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:TINUOLA
Other - Middle Name:KEMKOLA
Other - Last Name:BABARINDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:14741 W MOUNTAIN VIEW BLVD STE 149
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2704
Mailing Address - Country:US
Mailing Address - Phone:623-975-5400
Mailing Address - Fax:623-975-6004
Practice Address - Street 1:14741 W MOUNTAIN VIEW BLVD STE 149
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2704
Practice Address - Country:US
Practice Address - Phone:623-975-5400
Practice Address - Fax:623-975-6004
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29580208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ29580OtherSTATE LICENSE
AZ625246Medicaid