Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20A14251 | CA |
NPI | 1003287517 |
---|---|
Provider Name | Allandale Yap |
First Address | Glendale, CA 91205-4436 |
Second Address | Glendale, CA 91205-4436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2015 |
Last Update Date | 11/02/2022 |