Provider Demographics
NPI:1841066271
Name:ADDO-YIRENKYI
Entity type:Organization
Organization Name:ADDO-YIRENKYI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDO-YIRENKYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-763-8454
Mailing Address - Street 1:20557 CAITLIN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3804
Mailing Address - Country:US
Mailing Address - Phone:312-763-8454
Mailing Address - Fax:
Practice Address - Street 1:27141 HIDAWAY AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-4131
Practice Address - Country:US
Practice Address - Phone:312-763-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care