Provider Demographics
NPI:1164681938
Name:YAO, ELISA (MD)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:YAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 SHOWERS DR STE 7-212
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4740
Mailing Address - Country:US
Mailing Address - Phone:650-476-9193
Mailing Address - Fax:430-206-1884
Practice Address - Street 1:530 SHOWERS DR STE 7-212
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4740
Practice Address - Country:US
Practice Address - Phone:650-476-9193
Practice Address - Fax:430-206-1884
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105320208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation