Provider Demographics
NPI:1457857336
Name:GAO, YI (MD)
Entity Type:Individual
Prefix:DR
First Name:YI
Middle Name:
Last Name:GAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:GAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9250 N 3RD ST STE 3025
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:602-944-2805
Practice Address - Street 1:9250 N 3RD ST STE 3025
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2428
Practice Address - Country:US
Practice Address - Phone:602-944-4628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ66697207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZFG1644079OtherDEA