Basic Information
| Provider Information | |||||||||
| NPI: | 1487880274 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YAMANUHA | ||||||||
| FirstName: | JUSTIN | ||||||||
| MiddleName: | JAMES YUKIO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 WASHINGTON AVE SE STE 200 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554142924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126727422 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 516 DELAWARE ST SE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126254440 | ||||||||
| FaxNumber: | 6126267882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2009 | ||||||||
| LastUpdateDate: | 08/12/2019 | ||||||||
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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 | 207W00000X | ME119295 | FL | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | P6116 | TX | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 55730 | WI | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | MD-43103 | IA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | MDR-5720 | HI | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 59627 | MN | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.