Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A103120 | CA |
NPI | 1033588959 |
---|---|
Provider Name | Dr. Yuki Yasaka |
First Address | Shimajiri-Gun, OKINAWA 9011105 |
Second Address | Mesa, AZ 85202-4707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2015 |
Last Update Date | 21/09/2015 |