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NPI Code Detail

MEDICARE: SUNNY YINGLING RD, CSSD

MEDICARE: SUNNY YINGLING RD, CSSD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian989732CA

General Provider Information

NPI Number : 1376981753
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNNY YINGLING RD, CSSD
Provider Business Mailing Address
First Line : 8525 N CEDAR AVE
Second Line : STE. 109
City : FRESNO
State : CA
Zip : 93720-4833
Country : US
Telephone Number : 559-433-1120
Fax Number : 559-433-1102
Provider Business Practice Location Address
First Line : 8525 N CEDAR AVE
Second Line : STE. 109
City : FRESNO
State : CA
Zip : 93720-4833
Country : US
Telephone Number : 559-433-1120
Fax Number : 559-433-1102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2013
Last Update Date : 08/05/2015

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Directions to “ SUNNY YINGLING RD, CSSD” Practice Location

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