Healthcare Provider Details

I. General information

NPI: 1184988461
Provider Name (Legal Business Name): GRACE GUIMEI YAO M.D.,PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2012
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ODYSSEY STE 155
IRVINE CA
92618-3194
US

IV. Provider business mailing address

22 ODYSSEY STE 155
IRVINE CA
92618-3194
US

V. Phone/Fax

Practice location:
  • Phone: 949-418-7330
  • Fax: 844-269-8761
Mailing address:
  • Phone: 949-418-7330
  • Fax: 844-269-8761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA132410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: