Provider Demographics
NPI:1649383308
Name:YAMANE, RON H (MD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:H
Last Name:YAMANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1300 W 155TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4048
Mailing Address - Country:US
Mailing Address - Phone:310-327-6400
Mailing Address - Fax:310-327-2467
Practice Address - Street 1:1300 W 155TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4048
Practice Address - Country:US
Practice Address - Phone:310-327-6400
Practice Address - Fax:310-327-2467
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAF47485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG74242Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
CAF47485Medicare UPIN