Provider Demographics
NPI:1295936706
Name:YOSHIMURA, LYNN
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:YOSHIMURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 JOHNSON CT
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-2233
Mailing Address - Country:US
Mailing Address - Phone:310-977-1457
Mailing Address - Fax:
Practice Address - Street 1:6100 GEARY BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1910
Practice Address - Country:US
Practice Address - Phone:415-386-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist