Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | G48542 | CA |
NPI | 1013004852 |
---|---|
Provider Name | Dr. Mark K Yamanaka |
First Address | Oceanside, CA 92056-4510 |
Second Address | Oceanside, CA 92056-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 30/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E89636 | (02) | CA |