Provider Demographics
NPI:1043321789
Name:DAVIES, YINKA K (MD)
Entity Type:Individual
Prefix:
First Name:YINKA
Middle Name:K
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 GREENBACK LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-2013
Mailing Address - Country:US
Mailing Address - Phone:916-332-1244
Mailing Address - Fax:
Practice Address - Street 1:5767 GREENBACK LN
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-2013
Practice Address - Country:US
Practice Address - Phone:916-332-1244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA721352080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A721350Medicaid
H82911Medicare UPIN
00A721350Medicare ID - Type Unspecified