Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. KELLON OLUSOLA MD
NPI 1801517313
General Practice in Camarillo, CA

Q: What is Kellon Olusola's NPI number?

The NPI number for Kellon Olusola is 1801517313. It was assigned to this individual provider in the NPPES registry on September 5, 2022.

Q: What is Kellon Olusola's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Kellon Olusola was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 05, 2022PECOS Enrolled

4934 VERDUGO WAY, CAMARILLO, CA 93012(866) 944-6046(805) 388-2174 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 26, 2026, Sep 5, 2022 (2 updates tracked since 2022).

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About Dr. Kellon Olusola Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLON OLUSOLA MD (NPI 1801517313) is an individual general practice provider in Camarillo, California, licensed in California (A207193) and active in the NPI registry since September 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801517313

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. KELLON OLUSOLACredential: MD

Location Address4934 VERDUGO WAYCamarillo, CA 93012-8631

Mailing Address4934 Verdugo WayCamarillo, CA 93012-8631

Phone(866) 944-6046

Fax(805) 388-2174

Sole ProprietorNo

Enumeration DateSeptember 5, 2022

Last NPPES UpdateAugust 26, 20262 updates tracked since enumeration

NPPES CertifiedAugust 26, 2026

✔ NPI 1801517313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in CA · A207193

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

4934 VERDUGO WAY, Camarillo, CA 93012

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kellon Olusola Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMERICAN CURRENT CARE OF CALIFORNIA, A MEDICAL CORPORATION

Clinic/Center (Urgent Care)