Provider Demographics
NPI:1467529842
Name:MURO, YVONNE (PA-C)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:MURO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:PATRICIA
Other - Last Name:MURO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:686 MOWRY AVE.
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4113
Mailing Address - Country:US
Mailing Address - Phone:510-797-3933
Mailing Address - Fax:510-797-5184
Practice Address - Street 1:686 MOWRY AVE.
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4113
Practice Address - Country:US
Practice Address - Phone:510-797-3933
Practice Address - Fax:510-797-5184
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15738363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA15738OtherCA LICENSE