Basic Information
Provider Information
NPI: 1306999545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YUMUL
FirstName: ROYA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3530 WILSHIRE BLVD STE 350
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900102335
CountryCode: US
TelephoneNumber: 2136373703
FaxNumber: 2134273659
Practice Location
Address1: 8700 BEVERLY BLVD STE 8211
Address2:  
City: WEST HOLLYWOOD
State: CA
PostalCode: 900481804
CountryCode: US
TelephoneNumber: 2136373703
FaxNumber: 2134273659
Other Information
ProviderEnumerationDate: 01/19/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA64134CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home