Active NPI
Elliot Yamin
- Physician Assistant
- Alhambra, CA
National Provider Identifier
1083347330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA64715
- Practice address
- 1000 S Fremont Ave BLDG a-11
Alhambra, CA 91803-8800 - Phone
- (626) 457-4240
- NPI assigned
- Jul 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA64715 | CA | Primary |
Addresses
Primary practice location
1000 S Fremont Ave BLDG a-11
Alhambra, CA 91803-8800
Mailing address
24918 Bella Vista Dr
Calabasas, CA 91302-3035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA64715 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725580800000",
"number": "1083347330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24918 BELLA VISTA DR",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913023035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S FREMONT AVE BLDG A-11",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918038800",
"telephone_number": "626-457-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMIN",
"first_name": "ELLIOT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-05",
"last_updated": "2024-09-06",
"certification_date": "2024-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA64715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alhambra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.