Provider Demographics
NPI:1780065250
Name:YAKOBY, MATY (MD)
Entity type:Individual
Prefix:DR
First Name:MATY
Middle Name:
Last Name:YAKOBY
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 1:1107 E BELL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2691
Mailing Address - Country:US
Mailing Address - Phone:602-567-4800
Mailing Address - Fax:602-567-9939
Practice Address - Street 1:1107 E BELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2691
Practice Address - Country:US
Practice Address - Phone:602-567-4800
Practice Address - Fax:602-567-9939
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301113701207R00000X
AZ62958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine