Dr. Bobby K. Yang M.d. Medical Clinic, Llc | |
1047 University Ave W Suite 101 Saint Paul MN 55104-4751 | |
(651) 646-5452 | |
(651) 646-5658 |
Full Name | Dr. Bobby K. Yang M.d. Medical Clinic, Llc |
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Speciality | Clinic/center |
Location | 1047 University Ave W, Saint Paul, Minnesota |
Authorized Official Name and Position | Nou Thor (CLINIC MANAGER) |
Authorized Official Contact | 6516465452 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dr. Bobby K. Yang M.d. Medical Clinic, Llc 1047 University Ave W Suite 101 Saint Paul MN 55104-4751 Ph: (651) 646-5452 | Dr. Bobby K. Yang M.d. Medical Clinic, Llc 1047 University Ave W Suite 101 Saint Paul MN 55104-4751 Ph: (651) 646-5452 |
NPI Number | 1932389897 |
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Provider Enumeration Date | 11/08/2007 |
Last Update Date | 11/08/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932389897 | NPI | - | NPPES |
C03699 | Other | MN | MEDICARE GROUP |
604682700 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 43270 (Minnesota) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |