Healthcare Provider Details

I. General information

NPI: 1124760194
Provider Name (Legal Business Name): YOELBIS ALCOLEA TAMAYO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 WHITTIER BLVD STE 9
LOS ANGELES CA
90022-4577
US

IV. Provider business mailing address

6201 WHITTIER BLVD STE 9
LOS ANGELES CA
90022-4577
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone: 888-499-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA197709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: