Healthcare Provider Details

I. General information

NPI: 1972597458
Provider Name (Legal Business Name): YURIRIA S. LOBATO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 30TH ST #508
OAKLAND CA
94609-3310
US

IV. Provider business mailing address

411 30TH ST #508
OAKLAND CA
94609-3310
US

V. Phone/Fax

Practice location:
  • Phone: 925-274-4950
  • Fax: 925-274-4975
Mailing address:
  • Phone: 925-274-4950
  • Fax: 925-274-4975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA40940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: