Healthcare Provider Details
I. General information
NPI: 1104639996
Provider Name (Legal Business Name): YAFA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7235 W APPLETON AVE
MILWAUKEE WI
53216-1932
US
IV. Provider business mailing address
7235 W APPLETON AVE
MILWAUKEE WI
53216-1932
US
V. Phone/Fax
- Phone: 414-434-8517
- Fax: 414-365-2937
- Phone: 414-434-8517
- Fax: 414-365-2937
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YASIR
YAFAI
Title or Position: OWNER/DO
Credential: DO
Phone: 414-434-8517