Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Olubukola Fakunle

Individual provider Urology Physician · NPI 1134625874

Mary Olubukola Fakunle is an Urology in Santa Monica, California. Graduated from Rutgers New Jersey Medical School in 2018, 8 years ago. Works from 2 locations. Licensed in California.

Years since qualifying
8
Trained at
Rutgers New Jersey Medical School
Licensed in
CA
In the registry since
2018
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Practice location Address checks out

1260 15th St Ste 1200
Santa Monica, CA 90404-1147
Phone: (310) 794-7700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 513 Parnassus Ave # S321, San Francisco, CA 94143-2205 — (415) 476-1239

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence A163588 (CA)

Record details

NPI number1134625874
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 2, 2018
Last updated in NPPESJuly 2, 2024
Certification dateJuly 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolRUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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