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General NPI Number Information
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NPI Number | 1700943131
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Entity Type | Organization
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Legal Business Name | NORTHERN CALIF CHILDRENS HEMATOLOGY & ONCOLOGY MED GRP INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 5030 J STREET SUITE 200
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City | SACRAMENTO
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State | CA
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Zip | 95819
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Country | US
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Telephone | 906-469-9337
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Fax | 209-577-1509
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Provider Business Mailing Address
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Address Line | PO BOX 906
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City | SALIDA
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State | CA
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Zip | 95368
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Country | US
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Telephone | 209-577-9900
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Fax | 209-577-1509
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. YUNG YIM
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Credential | MD
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Telephone | 916-469-9337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number |
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License Number State |
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