Healthcare Provider Details

I. General information

NPI: 1144310350
Provider Name (Legal Business Name): KYOKO S YAMADA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 12/13/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 GEARY BLVD
SAN FRANCISCO CA
94115-3358
US

IV. Provider business mailing address

2425 GEARY BLVD
SAN FRANCISCO CA
94115-3358
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-4845
  • Fax: 415-833-2402
Mailing address:
  • Phone: 415-833-4845
  • Fax: 415-833-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA98584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: