Provider Demographics
NPI:1700079944
Name:YAMAGUCHI, SARAH KIYOMI (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KIYOMI
Last Name:YAMAGUCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 LUCAS AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1912
Mailing Address - Country:US
Mailing Address - Phone:213-977-4190
Mailing Address - Fax:213-250-4847
Practice Address - Street 1:637 LUCAS AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1912
Practice Address - Country:US
Practice Address - Phone:213-977-4190
Practice Address - Fax:213-250-4847
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103768207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology