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General NPI Number Information
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NPI Number | 1952994931
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Entity Type | Individual
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Provider Name | JUSTIN YAMAGUCHI DPT
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Gender | Male
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 250 E YALE LOOP STE. 201
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City | IRVINE
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State | CA
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Zip | 92604
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Country | US
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Telephone | 949-265-2442
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Fax | 714-256-0770
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Provider Business Mailing Address
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Address Line | 3230 E. IMPERIAL HWY SUITE 100
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City | BREA
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State | CA
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Zip | 92821-6735
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Country | US
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Telephone | 714-988-8110
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Fax | 714-988-8111
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 299866
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 299866
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License Number State | CA
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