Healthcare Provider Details

I. General information

NPI: 1598794331
Provider Name (Legal Business Name): ACCESS MEDICAL CARE A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6632 ROSEMEAD BLVD
PICO RIVERA CA
90660-3533
US

IV. Provider business mailing address

6632 ROSEMEAD BLVD
PICO RIVERA CA
90660-3533
US

V. Phone/Fax

Practice location:
  • Phone: 562-654-2828
  • Fax: 562-654-2830
Mailing address:
  • Phone: 562-654-2828
  • Fax: 562-654-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWIN TAN YU
Title or Position: PARTNER
Credential: M.D.
Phone: 562-654-2828