Healthcare Provider Details

I. General information

NPI: 1124091814
Provider Name (Legal Business Name): DENIS J YOSHII D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 ADAMS AVE STE 100
COSTA MESA CA
92626-4865
US

IV. Provider business mailing address

1700 ADAMS AVE STE 100
COSTA MESA CA
92626-4865
US

V. Phone/Fax

Practice location:
  • Phone: 714-549-0301
  • Fax: 714-549-7553
Mailing address:
  • Phone: 714-549-0301
  • Fax: 714-549-7553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number20A6936
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number1005
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: