Healthcare Provider Details

I. General information

NPI: 1588678833
Provider Name (Legal Business Name): DIANA K YAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 WORSHAM AVENUE SUITE 300
LONG BEACH CA
90808-1766
US

IV. Provider business mailing address

3833 WORSHAM AVENUE SUITE 300
LONG BEACH CA
90808-1766
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-5421
  • Fax: 562-426-2826
Mailing address:
  • Phone: 562-595-5421
  • Fax: 562-426-2826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG73884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: