Provider Demographics
NPI:1326693524
Name:YAQSA, INC.
Entity Type:Organization
Organization Name:YAQSA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YAKDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AL QAISI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-363-6800
Mailing Address - Street 1:4040 SAN DIMAS ST STE A
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1299
Mailing Address - Country:US
Mailing Address - Phone:661-363-6800
Mailing Address - Fax:661-324-6874
Practice Address - Street 1:4040 SAN DIMAS ST STE A
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1299
Practice Address - Country:US
Practice Address - Phone:661-363-6800
Practice Address - Fax:661-324-6874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty