Organization
YASH P SANGWAN M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YASH PAL SANGWAN M.D. (PRESIDENT)
(904) 261-6209
Entity
Organization
Contact information
Practice address
1411 S 14TH ST, STE C, FERNANDINA BEACH, FL 32034-3031
(904) 261-6209
(904) 261-0732
Mailing address
1411 S 14TH ST, SUITE C, FERNANDINA BEACH, FL 32034-3031
(904) 261-6209
(904) 261-0732
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME78773
FL
208C00000X
Colon & Rectal Surgery Physician
ME78773
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001122600
—
FL
01
—
E2938A
MEDICARE LEGACY NUMBER
FL
Enumeration date
07/13/2010
Last updated
07/28/2010
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