=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427369412
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN S YAMAS O.M.D., L.A.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2010
-----------------------------------------------------
Last Update Date | 06/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1460 G. STREET
-----------------------------------------------------
City | ARCATA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-822-7400
-----------------------------------------------------
Fax | 707-822-2338
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1460 G. STREET
-----------------------------------------------------
City | ARCATA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-822-7400
-----------------------------------------------------
Fax | 707-822-2338
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | ACCL002834
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------