Healthcare Provider Details

I. General information

NPI: 1437565298
Provider Name (Legal Business Name): DR. BARBARA S. YATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4804 LAUREL CANYON BLVD # 1200
VALLEY VILLAGE CA
91607-3717
US

IV. Provider business mailing address

4804 LAUREL CANYON BLVD # 1200
VALLEY VILLAGE CA
91607-3717
US

V. Phone/Fax

Practice location:
  • Phone: 310-709-8881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA97828
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License NumberA97828
License Number StateCA

VIII. Authorized Official

Name: DR. BARBARA YATES
Title or Position: PHYSICIAN
Credential: MD
Phone: 310-709-8881