MEDICARE: JIMMY T. UY, M.D., INC.

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
1	208000000X	Pediatrics Physician	A40328	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	A40328	OTHER	CA	MEDICARE ID

Other Identifiers

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

General Provider Information

NPI Number	:	1659561488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIMMY T. UY, M.D., INC.

Provider Business Mailing Address
First Line	:	3576 GRIFFITH PARK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-1444
Country	:	US
Telephone Number	:	323-662-9388
Fax Number	:	323-662-4945

Provider Business Practice Location Address
First Line	:	3576 GRIFFITH PARK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-1444
Country	:	US
Telephone Number	:	323-662-9388
Fax Number	:	323-662-4945

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	DR. JIMMY T UY
Credential	:	M.D.
Telephone Number	:	213-413-4777

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	05/29/2015

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