MEDICARE: DR. KENNETH M YAMASHIRO MD

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	207RG0100X	Gastroenterology Physician	G13929	CA

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	:	1669584934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH M YAMASHIRO MD

Provider Business Mailing Address
First Line	:	3055 W ORANGE AVE STE 105
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3152
Country	:	US
Telephone Number	:	714-995-4704
Fax Number	:	714-995-3814

Provider Business Practice Location Address
First Line	:	3055 W ORANGE AVE STE 105
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3152
Country	:	US
Telephone Number	:	714-995-4704
Fax Number	:	714-995-3814

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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