Healthcare Provider Details

I. General information

NPI: 1518565910
Provider Name (Legal Business Name): YOSHIAKI OTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CAMPUS VIEW BLVD STE 100
COLUMBUS OH
43235-8628
US

IV. Provider business mailing address

12605 E 16TH AVE
AURORA CO
80045-2545
US

V. Phone/Fax

Practice location:
  • Phone: 614-340-7740
  • Fax:
Mailing address:
  • Phone: 720-848-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberTL.0010471
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4352001057
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: