Healthcare Provider Details

I. General information

NPI: 1376646463
Provider Name (Legal Business Name): ADAM YARME M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13350 BIG BASIN WAY
BOULDER CREEK CA
95006-9237
US

IV. Provider business mailing address

1595 SOQUEL DR STE 330
SANTA CRUZ CA
95065-1719
US

V. Phone/Fax

Practice location:
  • Phone: 831-338-6491
  • Fax: 831-338-2767
Mailing address:
  • Phone: 831-465-7761
  • Fax: 831-475-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA88194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: