Healthcare Provider Details

I. General information

NPI: 1750167078
Provider Name (Legal Business Name): DOROTHY HANNAH YAMAGUCHI AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CONGRESS ST STE 300
PASADENA CA
91105-3027
US

IV. Provider business mailing address

PO BOX 1370
MONROVIA CA
91017-1370
US

V. Phone/Fax

Practice location:
  • Phone: 626-639-3182
  • Fax:
Mailing address:
  • Phone: 626-353-5114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: