MEDICARE: KENNETH S. YAMAMOTO, M.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	207R00000X	Internal Medicine Physician
2	207RH0003X	Hematology & Oncology Physician

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

General Provider Information

NPI Number	:	1548441660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNETH S. YAMAMOTO, M.D.

Provider Business Mailing Address
First Line	:	2645 OCEAN AVE
Second Line	:	SUITE 305
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1647
Country	:	US
Telephone Number	:	415-337-2121
Fax Number	:	415-337-1247

Provider Business Practice Location Address
First Line	:	2645 OCEAN AVE
Second Line	:	SUITE 305
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1647
Country	:	US
Telephone Number	:	415-337-2121
Fax Number	:	415-337-1247

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. ARLYNE TAMIYE YAMAMOTO
Credential	:
Telephone Number	:	415-337-2121

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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