Basic Information
| Provider Information | |||||||||
| NPI: | 1063831386 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YALON | ||||||||
| FirstName: | RON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 747 52ND ST. | ||||||||
| Address2: | ED ANNEX | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104283885 | ||||||||
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| Practice Location | |||||||||
| Address1: | 469 51ST ST | ||||||||
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| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946092143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512838599 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2014 | ||||||||
| LastUpdateDate: | 09/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A138748 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.