Provider Demographics
NPI:1568434819
Name:YALAM, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:YALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3020 E CAMELBACK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5095
Mailing Address - Country:US
Mailing Address - Phone:602-264-9100
Mailing Address - Fax:602-264-9101
Practice Address - Street 1:9755 N 90TH ST
Practice Address - Street 2:SUITE A205
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5046
Practice Address - Country:US
Practice Address - Phone:480-614-2215
Practice Address - Fax:480-614-2218
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2017-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ24488207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ558562Medicaid
AZ120390OtherGROUP MEDICARE NUMBER
AZ317047OtherGROUP MEDICAID NUMBER
H37408Medicare UPIN
AZ100016397Medicare PIN
AZ120395Medicare PIN
AZ558562Medicaid