Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | A45128 | CA |
NPI | 1083701007 |
---|---|
Provider Name | Mr. Yung Yim |
First Address | Salida, CA 95368 |
Second Address | Sacramento, CA 95819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A451280 | (05) | CA |
F12286 | (02) |