Healthcare Provider Details

I. General information

NPI: 1962475830
Provider Name (Legal Business Name): AUBREY YAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST PSSB-SUITE 1200
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

4150 V ST PSSB-SUITE 1200
SACRAMENTO CA
95817-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5630
  • Fax: 916-734-7980
Mailing address:
  • Phone: 916-734-5630
  • Fax: 916-734-7980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA82690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: