Healthcare Provider Details
I. General information
NPI: 1194878512
Provider Name (Legal Business Name): LAURO YAP ROBERTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/19/2007
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7471 N FRESNO ST
FRESNO CA
93720-2457
US
IV. Provider business mailing address
7471 N FRESNO ST
FRESNO CA
93720-2457
US
V. Phone/Fax
- Phone: 559-436-4500
- Fax: 559-261-1526
- Phone: 559-436-4500
- Fax: 559-261-1526
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | A049421 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | A49421 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: