MEDICARE: MR. RONALD YONEO HAYASHIDA O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	OPT4574T	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	FU077A	OTHER	CA	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1245517804	OTHER	CA	GROUP NPI

General Provider Information

NPI Number	:	1043294929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD YONEO HAYASHIDA O.D.

Provider Business Mailing Address
First Line	:	56970 YUCCA TRL
Second Line	:
City	:	YUCCA VALLEY
State	:	CA
Zip	:	92284-3753
Country	:	US
Telephone Number	:	760-228-2020
Fax Number	:	760-369-2020

Provider Business Practice Location Address
First Line	:	56970 YUCCA TRL
Second Line	:
City	:	YUCCA VALLEY
State	:	CA
Zip	:	92284-3753
Country	:	US
Telephone Number	:	760-228-2020
Fax Number	:	760-369-2020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2005
Last Update Date	:	06/21/2012

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Directions to “ MR. RONALD YONEO HAYASHIDA O.D.” Practice Location

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