St Paul Clinic Llc | |
301 University Ave W Saint Paul MN 55103-2048 | |
(651) 327-3839 | |
Not Available |
Full Name | St Paul Clinic Llc |
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Speciality | Clinic/Center |
Location | 301 University Ave W, Saint Paul, Minnesota |
Authorized Official Name and Position | Pa Foua Juliette Yang (VICE PRESIDENT) |
Authorized Official Contact | 6513273839 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St Paul Clinic Llc Po Box 532 Rosemount MN 55068-0532 Ph: (651) 327-3839 | St Paul Clinic Llc 301 University Ave W Saint Paul MN 55103-2048 Ph: (651) 327-3839 |
NPI Number | 1215334578 |
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Provider Enumeration Date | 12/02/2014 |
Last Update Date | 12/02/2014 |
Medicare PECOS PAC ID | 5991015851 |
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Medicare Enrollment ID | O20151104001455 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215334578 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Pafoua J Yang |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1922029529 PECOS PAC ID: 0941213334 Enrollment ID: I20060802000144 |
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