Healthcare Provider Details

I. General information

NPI: 1720161565
Provider Name (Legal Business Name): DONALD ARTHUR YOCHEM O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21825 OUTER HWY 18 SUITE A
APPLE VALLEY CA
92307
US

IV. Provider business mailing address

PO BOX 1423
APPLE VALLEY CA
92307-0026
US

V. Phone/Fax

Practice location:
  • Phone: 760-247-5842
  • Fax: 760-247-7250
Mailing address:
  • Phone: 760-247-5842
  • Fax: 760-247-7250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4658T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: