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NPI Code Detail

MEDICARE: STEPHANIE YAGI DO

MEDICARE: STEPHANIE YAGI DO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA
2207ZF0201XForensic Pathology PhysicianDO3172NV

General Provider Information

NPI Number : 1952872863
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE YAGI DO
Provider Business Mailing Address
First Line : 1704 PINTO LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4197
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8700 BEVERLY BLVD
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90048-1804
Country : US
Telephone Number : 310-423-6623
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2018
Last Update Date : 08/01/2022

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