Provider Demographics
NPI:1417995796
Name:YATES, JAMES D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:YATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:319 MANILA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-3239
Mailing Address - Country:US
Mailing Address - Phone:562-498-3135
Mailing Address - Fax:818-557-1394
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:818-557-1394
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA74258207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A742580OtherCALOPTIMA
CA00A742580Medicaid
CAA74258OtherBLUE CROSS
CA050126CG43851OtherVALLEY PRES TRAILBLAZER
CA930108080OtherVALLEY PRES RAILROAD
CA00A742580OtherBLUE SHIELD
CA930108080OtherVALLEY PRES RAILROAD
CAA74258OtherBLUE CROSS
CA050126CG43851OtherVALLEY PRES TRAILBLAZER