Kenneth Susumu Yamamoto, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

G313400 Issued in CA

Practice address

1800 Sullivan Ave
Suite 603
Daly City, CA 94015-2225

Phone

(415) 337-2121

Fax

(415) 337-1247

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467545368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 603",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152225",
            "telephone_number": "415-337-2121",
            "fax_number": "415-337-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 603",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152225",
            "telephone_number": "415-337-2121",
            "fax_number": "415-337-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "KENNETH",
        "middle_name": "SUSUMU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G31340",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G313400",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "G31340",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "G313400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G313400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chengyu Xu, M.D.
• Shuhong Xu
• Yun Lin Xue, MD
• Yama Med, a Professional Corporation
• Randy M Yamada, O.D.
• Yvette Yambao-Wacher
• Alice Lim Yan, M.D.
• Hui Ming Yang, MD
• Jennifer Kelly Yang, PHARM.D.
• Nereid Yang

• Medical Oncology Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Medical Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.