Provider Demographics
NPI:1649353095
Name:YASSINI, PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:YASSINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 ORANGE AVE
Mailing Address - Street 2:#100
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1408
Mailing Address - Country:US
Mailing Address - Phone:619-522-4005
Mailing Address - Fax:619-522-4014
Practice Address - Street 1:131 ORANGE AVE
Practice Address - Street 2:#100
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-1408
Practice Address - Country:US
Practice Address - Phone:619-522-4005
Practice Address - Fax:619-522-4014
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine