MEDICARE: DR. DAVID E YOMTOOB 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	207W00000X	Ophthalmology Physician	A107904	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1841487030	OTHER	CA	NPI
2	1225467038	OTHER	CA	ORGANIZATIONAL NPI

General Provider Information

NPI Number	:	1841487030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E YOMTOOB MD

Provider Business Mailing Address
First Line	:	3111 N TUSTIN ST STE 150
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-1752
Country	:	US
Telephone Number	:	714-771-1900
Fax Number	:	714-771-2020

Provider Business Practice Location Address
First Line	:	3111 N TUSTIN ST STE 150
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-1752
Country	:	US
Telephone Number	:	714-771-1900
Fax Number	:	714-771-2020

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

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	10/09/2024

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