Provider Demographics
NPI:1144232299
Name:YAMANE, IAN K (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:K
Last Name:YAMANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 N TENAYA WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0453
Mailing Address - Country:US
Mailing Address - Phone:702-309-4878
Mailing Address - Fax:702-658-7117
Practice Address - Street 1:2851 N TENAYA WAY STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0453
Practice Address - Country:US
Practice Address - Phone:702-309-4878
Practice Address - Fax:702-658-7117
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36667OtherMEDICARE PTN
NVV36667OtherMEDICARE PTN