Healthcare Provider Details

I. General information

NPI: 1760712699
Provider Name (Legal Business Name): TIMOTHY YAO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2009
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 ABBOTT ST STE 200
SALINAS CA
93901
US

IV. Provider business mailing address

355 ABBOTT ST STE 200
SALINAS CA
93901-4483
US

V. Phone/Fax

Practice location:
  • Phone: 831-422-3636
  • Fax: 831-422-1255
Mailing address:
  • Phone: 831-422-3636
  • Fax: 831-422-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number20700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: