=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346651221
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANNE AKEMI YAMANE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2014
-----------------------------------------------------
Last Update Date | 05/14/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22850 CRENSHAW BLVD 101
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90505-3045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-539-1444
-----------------------------------------------------
Fax | 310-530-2903
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22850 CRENSHAW BLVD 101
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90505-3045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-539-1444
-----------------------------------------------------
Fax | 310-530-2903
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. ANNE AKEMI YAMANE
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 310-539-1444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 41882
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------