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NPI Code Detail

MEDICARE: THOMAS FREDERICK YATTEAU

MEDICARE: THOMAS FREDERICK YATTEAU
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
1207Q00000XFamily Medicine PhysicianA35354CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A35354OTHERCACA STATE MEDICAL LICENSE#

General Provider Information

NPI Number : 1215947882
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS FREDERICK YATTEAU
Provider Business Mailing Address
First Line : 4725 HOEN AVE STE A
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-9405
Country : US
Telephone Number : 707-579-1400
Fax Number : 707-579-1411
Provider Business Practice Location Address
First Line : 4725 HOEN AVE STE A
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-9405
Country : US
Telephone Number : 707-579-1400
Fax Number : 707-579-1400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 03/07/2023

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Directions to “ THOMAS FREDERICK YATTEAU ” Practice Location

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