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General NPI Number Information
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NPI Number | 1962194084
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Entity Type | Organization
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Legal Business Name | KYLE YAMAMOTO, DDS, MD, MS, INC
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 22410 HAWTHORNE BLVD STE 3
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City | TORRANCE
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State | CA
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Zip | 90505-2594
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Country | US
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Telephone | 310-373-2238
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Fax |
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Provider Business Mailing Address
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Address Line | 22410 HAWTHORNE BLVD STE 3
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City | TORRANCE
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State | CA
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Zip | 90505-2594
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Country | US
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Telephone | 310-373-2238
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KYLE YAMAMOTO
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Credential | DDS, MD
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Telephone | 310-373-2238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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