1114242401 NPI number — MS. JANA AKEMI YONEMURA MS, OTR/L

Table of content: KUMUDA KUMAR MBBS (NPI 1548424484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114242401 NPI number — MS. JANA AKEMI YONEMURA MS, OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YONEMURA
Provider First Name:
JANA
Provider Middle Name:
AKEMI
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114242401
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8717 VENICE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90034-3216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-337-7115
Provider Business Mailing Address Fax Number:
310-216-6153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6315 ARIZONA PL
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90045-1252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-337-7115
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X , with the licence number:  OT 10748 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)