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General NPI Number Information
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NPI Number | 1730287327
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Entity Type | Organization
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Legal Business Name | KENTARO E YAMADA M.D. INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 1040 UNIVERSITY AVE STE B209A
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City | SAN DIEGO
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State | CA
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Zip | 92103-7328
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Country | US
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Telephone | 619-299-1100
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Fax | 619-299-7156
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Provider Business Mailing Address
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Address Line | 1040 UNIVERSITY AVE STE B209A
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City | SAN DIEGO
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State | CA
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Zip | 92103-7328
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Country | US
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Telephone | 161-929-9110
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Fax | 619-299-7156
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENTARO E YAMADA
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Credential | M.D.
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Telephone | 619-299-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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