Provider Demographics
NPI:1154145290
Name:GOMEZ YIM & RASTOGI, M.D., P.A.
Entity type:Organization
Organization Name:GOMEZ YIM & RASTOGI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-838-9555
Mailing Address - Street 1:602 S ATWOOD RD STE 104
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4198
Mailing Address - Country:US
Mailing Address - Phone:410-838-9555
Mailing Address - Fax:410-836-5056
Practice Address - Street 1:253 LEWIS LN STE 203
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3756
Practice Address - Country:US
Practice Address - Phone:410-939-0696
Practice Address - Fax:410-939-6210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEL AIR PEDIATRIC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Multi-Specialty