Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 48419 | AZ |
NPI | 1053543009 |
---|---|
Provider Name | Yanal Masannat |
First Address | Yuma, AZ 85364-8875 |
Second Address | Yuma, AZ 85364-7726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2009 |
Last Update Date | 15/07/2019 |