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NPI Code Detail

MEDICARE: DR. ZEWDU YITAGESU GEBREYES M.D.

MEDICARE: DR. ZEWDU YITAGESU GEBREYES M.D.
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
1207R00000XInternal Medicine PhysicianA63698CA

General Provider Information

NPI Number : 1366419541
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ZEWDU YITAGESU GEBREYES M.D.
Provider Business Mailing Address
First Line : 450 E HUNTINGTON DR
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3748
Country : US
Telephone Number : 626-462-1891
Fax Number : 626-445-5024
Provider Business Practice Location Address
First Line : 450 E HUNTINGTON DR
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3748
Country : US
Telephone Number : 626-462-1891
Fax Number : 626-445-5024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 10/17/2012

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