Provider Demographics
NPI:1053676619
Name:YERRO, GLADYS HOPE DADIVAS (MD)
Entity Type:Individual
Prefix:DR
First Name:GLADYS HOPE
Middle Name:DADIVAS
Last Name:YERRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14555 HAMLIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1617
Mailing Address - Country:US
Mailing Address - Phone:818-781-2796
Mailing Address - Fax:818-781-2797
Practice Address - Street 1:14555 HAMLIN ST STE 108
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1617
Practice Address - Country:US
Practice Address - Phone:818-781-2796
Practice Address - Fax:818-781-2797
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA485532080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine