Healthcare Provider Details
I. General information
NPI: 1215065891
Provider Name (Legal Business Name): LAL KAYE YILMAZ-GONZALEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/02/2007
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41 DE SILVA ISLAND DR
MILL VALLEY CA
94941-3024
US
IV. Provider business mailing address
1425 S MAIN ST
WALNUT CREEK CA
94596-5318
US
V. Phone/Fax
- Phone: 415-476-1236
- Fax:
- Phone: 925-295-7930
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A71198 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: