MEDICARE: EDMUND YAO MD INC

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	207R00000X	Internal Medicine Physician	A84312	CA

General Provider Information

NPI Number	:	1285969139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDMUND YAO MD INC

Provider Business Mailing Address
First Line	:	PO BOX 691957
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95269-1957
Country	:	US
Telephone Number	:	209-662-0224
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 W MARCH LN STE 101
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95219-6568
Country	:	US
Telephone Number	:	209-472-7100
Fax Number	:	209-472-7108

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDMUND C YAO
Credential	:	MD
Telephone Number	:	209-662-0224

Provider Enumeration Date	:	10/10/2009
Last Update Date	:	12/30/2019

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