Provider Demographics
NPI:1801623558
Name:YIVORY HEALTHCARE INC.
Entity type:Organization
Organization Name:YIVORY HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-321-6353
Mailing Address - Street 1:30021 TOMAS STE 300
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2128
Mailing Address - Country:US
Mailing Address - Phone:888-857-9528
Mailing Address - Fax:305-766-0219
Practice Address - Street 1:30021 TOMAS STE 300
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2128
Practice Address - Country:US
Practice Address - Phone:888-857-9528
Practice Address - Fax:305-766-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty