Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G24836 | CA |
Y | 208600000X | Surgeon | G24836 | CA |
N | 2082S0105X | Plastic Hand Surgeon | G24836 | CA |
NPI | 1124042924 |
---|---|
Provider Name | Kent Yamaguchi |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93720-8016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 22/03/2016 |