Provider Demographics
NPI:1164017513
Name:YOSEMITE BONE AND JOINT, INC.
Entity Type:Organization
Organization Name:YOSEMITE BONE AND JOINT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:ABNER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-723-2799
Mailing Address - Street 1:240 E 13TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6234
Mailing Address - Country:US
Mailing Address - Phone:209-723-2799
Mailing Address - Fax:
Practice Address - Street 1:200 COTTAGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4935
Practice Address - Country:US
Practice Address - Phone:209-723-2799
Practice Address - Fax:209-723-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty