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General NPI Number Information
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NPI Number | 1275181877
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Entity Type | Individual
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Provider Name | YONAS WORKU
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Gender | Male
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 3567 MT. WHITNEY AVENUE
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City | RIVERDALE
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State | CA
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Zip | 93656
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Country | US
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Telephone | 559-867-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 W B ST APT 24
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City | ONTARIO
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State | CA
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Zip | 91762-3344
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Country | US
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Telephone | 213-268-1901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA57143
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License Number State | CA
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