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General NPI Number Information
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NPI Number | 1235309980
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Entity Type | Organization
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Legal Business Name | DR. MICHAEL YAVROM DPM PODIATRIST
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 08/31/2008
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Provider Practice Location Address
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Address Line | 2500 HOSPITAL DR STE 1
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4106
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Country | US
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Telephone | 650-961-1995
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Fax | 650-961-2781
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Provider Business Mailing Address
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Address Line | 2500 HOSPITAL DR STE 1
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4106
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Country | US
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Telephone | 650-961-1995
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Fax | 650-961-2781
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL YAVROM
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Credential | DPM
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Telephone | 650-961-1995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E1204
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License Number State | CA
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