Healthcare Provider Details

I. General information

NPI: 1134330921
Provider Name (Legal Business Name): YESIM YILMAZ DEMIRDAG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YESIM DEMIRDAG MD

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 HEALTH SCIENCES RD MEDICAL SCIENCES I C-240
IRVINE CA
92697-9214
US

IV. Provider business mailing address

PO BOX 9214 WEST VIRGINIA UNIVERSITY
MORGANTOWN WV
26506-9214
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-5818
  • Fax:
Mailing address:
  • Phone: 304-293-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberC166841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: