Provider Demographics
NPI:1366636052
Name:ALAN Y. YAMASHIRO, MD, INC.
Entity Type:Organization
Organization Name:ALAN Y. YAMASHIRO, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:YAMASHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-718-3600
Mailing Address - Street 1:450 NEWPORT CENTER DRIVE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7641
Mailing Address - Country:US
Mailing Address - Phone:949-999-3600
Mailing Address - Fax:949-999-8365
Practice Address - Street 1:1441 AVOCADO AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7721
Practice Address - Country:US
Practice Address - Phone:949-718-3600
Practice Address - Fax:949-999-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50847174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA93014Medicare UPIN