Provider Demographics
NPI:1689014821
Name:YADATORE, APARNA (MD)
Entity Type:Individual
Prefix:DR
First Name:APARNA
Middle Name:
Last Name:YADATORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YADATORE
Other - Middle Name:CHANDRASHEKAR
Other - Last Name:APARNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:1910 CUSTOMER CARE WAY
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5167
Mailing Address - Country:US
Mailing Address - Phone:209-384-6488
Mailing Address - Fax:
Practice Address - Street 1:1510 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4437
Practice Address - Country:US
Practice Address - Phone:209-549-7090
Practice Address - Fax:209-549-7099
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA148533208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics