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General NPI Number Information
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NPI Number | 1215051669
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Entity Type | Individual
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Provider Name | ROUPEN YAGHSEZIAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 22632 OCEAN WAY
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5436
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Country | US
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Telephone | 951-280-0100
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Fax | 951-280-0194
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Provider Business Mailing Address
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Address Line | 22632 OCEAN WAY
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5436
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Country | US
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Telephone | 951-280-0100
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Fax | 951-280-0194
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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 | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | A52567
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License Number State | CA
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