Healthcare Provider Details

I. General information

NPI: 1922063601
Provider Name (Legal Business Name): AYAKO YANO MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N SAN MATEO DR NIHON BAY CLINIC
SAN MATEO CA
94401-2824
US

IV. Provider business mailing address

40 N SAN MATEO DR NIHON BAY CLINIC
SAN MATEO CA
94401-2824
US

V. Phone/Fax

Practice location:
  • Phone: 650-558-0337
  • Fax: 650-558-9364
Mailing address:
  • Phone: 650-558-0337
  • Fax: 650-558-9364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: