Basic Information
| Provider Information | |||||||||
| NPI: | 1003859802 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YAMAMOTO | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | ALAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3565 DEL AMO BLVD | ||||||||
| Address2: | 3RD FLOOR DERMATOLOGY | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102140811 | ||||||||
| FaxNumber: | 3103715262 | ||||||||
| Practice Location | |||||||||
| Address1: | 3565 DEL AMO BLVD | ||||||||
| Address2: | 3RD FLOOR DERMATOLOGY | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102140811 | ||||||||
| FaxNumber: | 3103715262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 01/15/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | A48496 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.