Basic Information
| Provider Information | |||||||||
| NPI: | 1508440967 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOMI | ||||||||
| FirstName: | TIMIIYE | ||||||||
| MiddleName: | DAWN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MBBS, MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SUNWENGHAN | ||||||||
| OtherFirstName: | TIMIIYE | ||||||||
| OtherMiddleName: | DAWN | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MBBS, MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | EAST NILES COMMUNITY HEALTH CENTER | ||||||||
| Address2: | 7800 NILES ST | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613284284 | ||||||||
| FaxNumber: | 6616169977 | ||||||||
| Practice Location | |||||||||
| Address1: | EAST NILES COMMUNITY HEALTH CENTER | ||||||||
| Address2: | 7800 NILES ST | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613284284 | ||||||||
| FaxNumber: | 6616169977 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2021 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | PTL5685 | CA | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.