=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285722694
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YAMAMOTO OPTOMETRIC CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2006
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7215 N 1ST ST SUITE 101
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93720-2985
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-226-3937
-----------------------------------------------------
Fax | 559-226-8305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7215 N 1ST ST STE 101
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93720-2985
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-226-3937
-----------------------------------------------------
Fax | 559-226-8305
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ALYSSA MIDORI YAMAMOTO
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 559-226-3937
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------