Provider Demographics
NPI:1598828253
Name:RONALD R UYEYAMA M D INC
Entity Type:Organization
Organization Name:RONALD R UYEYAMA M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:RANORU
Authorized Official - Last Name:UYEYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-642-5442
Mailing Address - Street 1:2101 FOREST AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1448
Mailing Address - Country:US
Mailing Address - Phone:408-642-5442
Mailing Address - Fax:408-642-5697
Practice Address - Street 1:2101 FOREST AVE
Practice Address - Street 2:STE 102
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1448
Practice Address - Country:US
Practice Address - Phone:408-642-5442
Practice Address - Fax:408-642-5697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21121261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA22465Medicare UPIN
CA00A211210Medicare ID - Type Unspecified