Healthcare Provider Details

I. General information

NPI: 1831357714
Provider Name (Legal Business Name): JUMI YI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH & CIVIC CENTER BLVD. CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

747 52ND ST
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1000
  • Fax: 215-590-2180
Mailing address:
  • Phone: 215-567-2422
  • Fax: 215-561-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA150615
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberA150615
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD439825
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: