MEDICARE: WILLIAM YANOWSKY ATC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1215072830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM YANOWSKY ATC

Provider Business Mailing Address
First Line	:	4252 CRESCENDO AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95136-2113
Country	:	US
Telephone Number	:	408-504-9866
Fax Number	:

Provider Business Practice Location Address
First Line	:	4252 CRESCENDO AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95136-2113
Country	:	US
Telephone Number	:	408-504-9866
Fax Number	:

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	08/10/2023

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