Provider Demographics
NPI:1447755764
Name:JAMORA, JOHN YAP (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:YAP
Last Name:JAMORA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 N REYNOLDS RD STE 170
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2076
Mailing Address - Country:US
Mailing Address - Phone:419-578-7510
Mailing Address - Fax:419-537-5605
Practice Address - Street 1:2865 N REYNOLDS RD STE 170
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2076
Practice Address - Country:US
Practice Address - Phone:419-578-7510
Practice Address - Fax:419-537-5605
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOL61068377207Q00000X
OH34.016643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2160289Medicaid