Provider Demographics
NPI:1588033773
Name:DR. GRACE GUIMEI YAO, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR. GRACE GUIMEI YAO, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:GUIMEI
Authorized Official - Last Name:YAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-369-9962
Mailing Address - Street 1:22 ODYSSEY STE 155
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3194
Mailing Address - Country:US
Mailing Address - Phone:949-418-7330
Mailing Address - Fax:844-269-8761
Practice Address - Street 1:22 ODYSSEY STE 155
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3194
Practice Address - Country:US
Practice Address - Phone:949-418-7330
Practice Address - Fax:844-269-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132410174400000X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty