MEDICARE: YORDANOS DEGU ZEWDU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1174482947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YORDANOS DEGU ZEWDU

Provider Business Mailing Address
First Line	:	411 FAIRMOUNT AVE APT 307
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-5563
Country	:	US
Telephone Number	:	510-944-6640
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 FAIRMOUNT AVE APT 307
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-5563
Country	:	US
Telephone Number	:	510-944-6640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ YORDANOS DEGU ZEWDU ” Practice Location

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