MEDICARE: ROLANDO G. UYKIMPANG M.D.

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
1	208D00000X	General Practice Physician	A91957	CA

General Provider Information

NPI Number	:	1992782163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLANDO G. UYKIMPANG M.D.

Provider Business Mailing Address
First Line	:	10399 LEMON AVE STE 102B
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91737-3771
Country	:	US
Telephone Number	:	909-481-1002
Fax Number	:	909-481-1132

Provider Business Practice Location Address
First Line	:	10399 LEMON AVE STE 102B
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91737-3771
Country	:	US
Telephone Number	:	909-481-1002
Fax Number	:	909-481-1132

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	06/18/2014

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