Healthcare Provider Details

I. General information

NPI: 1528897717
Provider Name (Legal Business Name): MR. YAHN ISRAEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 NW 39TH EXPRESSWAY
OKLAHOMA CITY OK
73112-6309
US

IV. Provider business mailing address

905 N KEY BLVD
MIDWEST CITY OK
73110-5417
US

V. Phone/Fax

Practice location:
  • Phone: 405-857-8280
  • Fax:
Mailing address:
  • Phone: 405-623-1856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: