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Organization
STANLEY Y. LOUIE DO, INC
Active
Organization
STANLEY Y. LOUIE DO, INC
Active
Other names
Logan Street Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY YOUNG LOUIE DO (PRESIDEN/MEDICAL DIRECTOR)
(559) 896-2624
Entity
Organization
Contact information
Practice address
2511 LOGAN ST, SELMA, CA 93662-3012
(559) 896-2624
(559) 896-3235
Mailing address
2511 LOGAN ST, SELMA, CA 93662-3012
(559) 896-2624
(559) 896-3235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A65700
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A65700
BLUE CROSS
CA
05
—
GR0081530
—
CA
01
—
ZZZ53815Z
BLUE SHIELD
CA
Enumeration date
07/22/2005
Last updated
08/22/2020
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