Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | C43367 | CA |
NPI | 1124061148 |
---|---|
Provider Name | Jay H. Yoo |
First Address | Bakersfield, CA 93312 |
Second Address | Bakersfield, CA 93309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 02/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C433670 | (05) | CA |
D 35435 | (02) | CA |
D35435 | (02) | CA |