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General NPI Number Information
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NPI Number | 1124152178
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Entity Type | Individual
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Provider Name | RICHARD LESTER YUKL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24382 LAWTON AVE
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City | LOMA LINDA
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State | CA
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Zip | 92354-3338
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Country | US
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Telephone | 909-796-6472
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Fax | 909-796-6472
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Provider Business Mailing Address
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Address Line | PO BOX 1159
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City | LOMA LINDA
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State | CA
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Zip | 92354-1159
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Country | US
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Telephone | 909-796-6472
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Fax | 909-796-6472
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G87341
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35878
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License Number State | IA
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