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General NPI Number Information
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NPI Number | 1245328004
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Entity Type | Individual
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Provider Name | EDMUND CO YAO M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 3031 W MARCH LN STE 101
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City | STOCKTON
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State | CA
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Zip | 95219-6568
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Country | US
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Telephone | 209-472-7100
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Fax | 209-472-7108
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Provider Business Mailing Address
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Address Line | PO BOX 691957
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City | STOCKTON
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State | CA
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Zip | 95269-1957
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Country | US
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Telephone | 209-472-7100
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Fax | 209-472-7108
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A84312
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License Number State | CA
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