Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A48496 | CA |
NPI | 1003859802 |
---|---|
Provider Name | Dr. Richard Alan Yamamoto |
First Address | Torrance, CA 90503 |
Second Address | Torrance, CA 90503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 15/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F79921 | (02) | CA |