Provider Demographics
NPI:1003859802
Name:YAMAMOTO, RICHARD ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:YAMAMOTO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3565 DEL AMO BLVD
Mailing Address - Street 2:3RD FLOOR DERMATOLOGY
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-214-0811
Mailing Address - Fax:310-371-5262
Practice Address - Street 1:3565 DEL AMO BLVD
Practice Address - Street 2:3RD FLOOR DERMATOLOGY
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-214-0811
Practice Address - Fax:310-371-5262
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA48496207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF79921Medicare UPIN