Provider Demographics
NPI:1750493516
Name:YOSHINO, SUSAN J (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:YOSHINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4065 COUNTY CIRCLE DR RM 306
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3410
Mailing Address - Country:US
Mailing Address - Phone:951-358-6057
Mailing Address - Fax:951-358-6044
Practice Address - Street 1:7140 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4544
Practice Address - Country:US
Practice Address - Phone:951-358-6057
Practice Address - Fax:951-358-6044
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A8603CMedicare UPIN
CAW20A8603BMedicare UPIN
CAW20A8603DMedicare UPIN
CAW20A8603AMedicare UPIN