Provider Demographics
NPI:1669081709
Name:YOAKIM, MICHELLE KALIOPA (DPM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KALIOPA
Last Name:YOAKIM
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6070
Mailing Address - Country:US
Mailing Address - Phone:970-810-2815
Mailing Address - Fax:
Practice Address - Street 1:400 NEWPORT CENTER DR STE 706
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7661
Practice Address - Country:US
Practice Address - Phone:949-706-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
COPDT.0000597390200000X
CAE6057213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program