Provider Demographics
NPI:1407868375
Name:YOSHIYAMA, JON YOSHITO (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:YOSHITO
Last Name:YOSHIYAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 ACAPULCO WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-4004
Mailing Address - Country:US
Mailing Address - Phone:831-424-2932
Mailing Address - Fax:
Practice Address - Street 1:219 N SANBORN RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2218
Practice Address - Country:US
Practice Address - Phone:831-757-1365
Practice Address - Fax:831-757-2824
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A547690Medicaid
CAH12770Medicare UPIN
CA00A547690Medicare ID - Type Unspecified