Healthcare Provider Details
I. General information
NPI: 1871252874
Provider Name (Legal Business Name): BOOKADOC2U LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2021
Last Update Date: 12/17/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1560 HUMBOLDT RD STE 2
CHICO CA
95928-9101
US
IV. Provider business mailing address
1560 HUMBOLDT RD STE 2
CHICO CA
95928-9101
US
V. Phone/Fax
- Phone: 530-569-6263
- Fax: 415-569-6267
- Phone: 530-569-6263
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AKUA
AGYEMAN
Title or Position: CEO
Credential: MD PHD
Phone: 415-321-9868