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General NPI Number Information
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NPI Number | 1972493500
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Entity Type | Organization
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Legal Business Name | MARIE YADAO PLLC
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 9420 W SAHARA AVE STE 105
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City | LAS VEGAS
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State | NV
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Zip | 89117-8800
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Country | US
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Telephone | 702-330-0901
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 GRANT ST
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City | SANTA MONICA
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State | CA
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Zip | 90405-1411
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Country | US
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Telephone | 201-961-3356
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Fax |
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Authorized Official
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Title or Position | OWNER & CLINICAL DIRECTOR
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Name | MARIE YADAO
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Credential | APRN
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Telephone | 702-330-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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