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General NPI Number Information
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NPI Number | 1164475109
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Entity Type | Organization
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Legal Business Name | RONALD R. YAMADA, M.D., INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1234 E NORTH ST SUITE 103
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City | MANTECA
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State | CA
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Zip | 95336-4960
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Country | US
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Telephone | 209-824-8111
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Fax | 209-824-8200
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Provider Business Mailing Address
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Address Line | 1234 E NORTH ST SUITE 103
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City | MANTECA
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State | CA
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Zip | 95336-4960
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Country | US
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Telephone | 209-824-8111
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Fax | 209-824-8200
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD R. YAMADA
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Credential | M.D.
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Telephone | 209-824-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G30653
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License Number State | CA
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