Organization Active NPI

Marina Yam MD Professional Corporation

  • Pediatrics Physician
  • Los Gatos, CA
National Provider Identifier
1447948864
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MARINA YAM MD PROFESSIONAL CORPORATION
Practice address
825 Pollard Rd Ste 109
Los Gatos, CA 95032-1435
Phone
(408) 376-3666
NPI assigned
Apr 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marina Yam, MDNPI 1538107636
Title
President
Phone
(408) 455-2959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

825 Pollard Rd Ste 109
Los Gatos, CA 95032-1435

Mailing address

17608 Vineland CT
Monte Sereno, CA 95030-3226
Phone (408) 455-2959

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1068681Marina Yam, MD825 Pollard Rd, #109, Los Gatos, CA 95032Certificate of waiverMay 17, 2027

National Provider Directory

National Provider Directory

Locations

825 Pollard Rd
Ste 109
Los Gatos, CA 95032
Phone (408) 376-3666

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1447948864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17608 VINELAND CT",
            "city": "MONTE SERENO",
            "state": "CA",
            "postal_code": "950303226",
            "telephone_number": "408-455-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD STE 109",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-376-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA YAM MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "YAM",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-455-2959",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.