Provider Demographics
NPI:1255487773
Name:CAPITAL MEDICAL ASSOCIATES -YAMAMOTO-VANEPPS-FORMAN-PINTAR LTD
Entity Type:Organization
Organization Name:CAPITAL MEDICAL ASSOCIATES -YAMAMOTO-VANEPPS-FORMAN-PINTAR LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:I
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-283-3220
Mailing Address - Street 1:2874 N CARSON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0177
Mailing Address - Country:US
Mailing Address - Phone:775-283-3220
Mailing Address - Fax:775-883-2936
Practice Address - Street 1:2874 N CARSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0177
Practice Address - Country:US
Practice Address - Phone:775-283-3220
Practice Address - Fax:775-883-2936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV32925Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER