Provider Demographics
NPI:1497281760
Name:ADAM HY DO
Entity Type:Organization
Organization Name:ADAM HY DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HY
Authorized Official - Suffix:
Authorized Official - Credentials:D,O,
Authorized Official - Phone:626-810-5272
Mailing Address - Street 1:18897 COLIMA RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2977
Mailing Address - Country:US
Mailing Address - Phone:626-810-5272
Mailing Address - Fax:
Practice Address - Street 1:18897 COLIMA RD
Practice Address - Street 2:SUITE C
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2977
Practice Address - Country:US
Practice Address - Phone:626-810-5272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7891Medicare PIN