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NPI Code Detail

MEDICARE: CHRISTIAN LY CORNEJO YUMPE M.D.

MEDICARE: CHRISTIAN LY CORNEJO YUMPE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician0101240007VA
2208000000XPediatrics PhysicianMD038358DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20101240007OTHERVAMEDICAL LICENSE

General Provider Information

NPI Number : 1568578862
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN LY CORNEJO YUMPE M.D.
Provider Business Mailing Address
First Line : 601 S CARLIN SPRINGS RD
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-1044
Country : US
Telephone Number : 703-271-8800
Fax Number : 703-271-8585
Provider Business Practice Location Address
First Line : 2333 ONTARIO RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2627
Country : US
Telephone Number : 202-545-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 11/08/2024

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