Provider Demographics
NPI:1508912908
Name:TARO YOKOYAMA, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TARO YOKOYAMA, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:PACIFIC CARDIOTHORACIC SURGERY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKOYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA MA
Authorized Official - Phone:213-620-0959
Mailing Address - Street 1:201 S ALVARADO ST
Mailing Address - Street 2:STE 702
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2320
Mailing Address - Country:US
Mailing Address - Phone:213-639-2200
Mailing Address - Fax:213-368-7739
Practice Address - Street 1:201 S ALVARADO ST
Practice Address - Street 2:STE 702
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2320
Practice Address - Country:US
Practice Address - Phone:213-639-2200
Practice Address - Fax:213-368-7739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25613208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ14128ZOtherBLUE SHIELD GROUP NUMBER
CAGR0026700Medicaid
CAW10119Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
CACI3545Medicare ID - Type UnspecifiedMEDICARE RAILROAD GROUP
CAGR0026700Medicaid
CAW10119AMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER