Healthcare Provider Details

I. General information

NPI: 1275169302
Provider Name (Legal Business Name): JOHN S. YAO MD FACP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 BRANNAN ST UNIT 15C
SAN FRANCISCO CA
94107-4059
US

IV. Provider business mailing address

PO BOX 191202
SAN FRANCISCO CA
94119-1202
US

V. Phone/Fax

Practice location:
  • Phone: 415-308-9278
  • Fax:
Mailing address:
  • Phone: 415-308-9278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG54622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: