Healthcare Provider Details

I. General information

NPI: 1699784975
Provider Name (Legal Business Name): YASHWANT GIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N ROSE DR
PLACENTIA CA
92870-3802
US

IV. Provider business mailing address

PO BOX 4259
CERRITOS CA
90703-4259
US

V. Phone/Fax

Practice location:
  • Phone: 562-407-2080
  • Fax:
Mailing address:
  • Phone: 562-407-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC51755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: