Healthcare Provider Details

I. General information

NPI: 1043133234
Provider Name (Legal Business Name): PAULINE YASMEH MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11870 IDAHO AVE
LOS ANGELES CA
90025-2897
US

IV. Provider business mailing address

11870 IDAHO AVE APT 102
LOS ANGELES CA
90025-2895
US

V. Phone/Fax

Practice location:
  • Phone: 310-999-9456
  • Fax:
Mailing address:
  • Phone: 310-999-9456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAULINE YASMEH
Title or Position: PHYSICIAN
Credential: MD
Phone: 310-999-9456