Provider Demographics
NPI:1578941563
Name:KYLE T. YAMAMOTO, MD, LTD.
Entity Type:Organization
Organization Name:KYLE T. YAMAMOTO, MD, LTD.
Other - Org Name:SIERRA NEVADA COSMETIC AND LASER SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-223-9493
Mailing Address - Street 1:3614 LAKESIDE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5285
Mailing Address - Country:US
Mailing Address - Phone:775-525-1712
Mailing Address - Fax:775-499-5676
Practice Address - Street 1:3614 LAKESIDE DR STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5285
Practice Address - Country:US
Practice Address - Phone:775-525-1712
Practice Address - Fax:775-499-5676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15693207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty