Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A25613 | CA |
NPI | 1023090784 |
---|---|
Provider Name | Dr. Taro Yokoyama |
First Address | Los Angeles, CA 90057-1932 |
Second Address | Los Angeles, CA 90057-1932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 25/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A256130 | (05) | CA |
00A256130L95 | (05) | CA |
A24512 | (02) | CA |
GR0026700 | (05) | CA |