Provider Demographics
NPI:1780788794
Name:YAMAMOTO, KAZUNORI (MD)
Entity type:Individual
Prefix:DR
First Name:KAZUNORI
Middle Name:
Last Name:YAMAMOTO
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:VETERANS AFFAIRS HOSPITAL, AMERICAN LAKE
Mailing Address - Street 2:VETERANS DRIVE, S.W.
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-5000
Mailing Address - Country:US
Mailing Address - Phone:253-583-1208
Mailing Address - Fax:253-589-4186
Practice Address - Street 1:VETERANS AFFAIRS HOSPITAL AMERICAN LAKE CAMPUS
Practice Address - Street 2:VETERANS DRIVE, S.W.
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-583-1208
Practice Address - Fax:253-589-4186
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00034420207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology