Provider Demographics
NPI:1568423465
Name:YONEDA, KEN Y (MD)
Entity Type:Individual
Prefix:DR
First Name:KEN
Middle Name:Y
Last Name:YONEDA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4150 V ST
Mailing Address - Street 2:SUITE 3400 DIVISION OF PULMONARY AND CRITICAL CARE MED
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-734-3564
Mailing Address - Fax:916-734-7924
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:UNIVERSITY OF CALIFORNIA DAVIS HEALTH SYSTEM
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-3564
Practice Address - Fax:916-734-7924
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG768650207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG768650Medicaid
E97922Medicare UPIN
CAG768650Medicare ID - Type Unspecified