Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A151560 | CA |
NPI | 1013379841 |
---|---|
Provider Name | Miss Stephanie Yan |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817-1460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 22/10/2021 |