Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A145033 | CA |
Y | 111NI0900X | Internist | A145033 | CA |
NPI | 1003294661 |
---|---|
Provider Name | Sang Yim |
First Address | Riverside, CA 92506-2658 |
Second Address | Riverside, CA 92506-2658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 24/02/2020 |