Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 39581 | CA |
NPI | 1124234141 |
---|---|
Provider Name | Dr. Craig Yutaka Yonemura |
First Address | San Francisco, CA 94102-1117 |
Second Address | San Francisco, CA 94102-1117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |