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General NPI Number Information
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NPI Number | 1376782227
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Entity Type | Organization
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Legal Business Name | YUBA CITY PRIMARY CARE AND DIABETES 2 CLINIC, INC.
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 481 PLUMAS BLVD SUITE 104
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City | YUBA CITY
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State | CA
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Zip | 95991-5075
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Country | US
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Telephone | 530-674-2434
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Fax | 530-674-2704
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Provider Business Mailing Address
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Address Line | 481 PLUMAS BLVD SUITE 104
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City | YUBA CITY
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State | CA
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Zip | 95991-5075
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Country | US
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Telephone | 530-674-2434
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Fax | 530-674-2704
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASBIR S. KANG
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Credential | M.D.
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Telephone | 530-674-2434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A46605
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License Number State | CA
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