Provider Demographics
NPI:1164475109
Name:RONALD R. YAMADA, M.D., INC
Entity Type:Organization
Organization Name:RONALD R. YAMADA, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:YAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-824-8111
Mailing Address - Street 1:1234 E NORTH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-4960
Mailing Address - Country:US
Mailing Address - Phone:209-824-8111
Mailing Address - Fax:209-824-8200
Practice Address - Street 1:1234 E NORTH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4960
Practice Address - Country:US
Practice Address - Phone:209-824-8111
Practice Address - Fax:209-824-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30653207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty