Brent Tatsuo Yamamoto
Individual provider Active NPI Pharmacist · Caruthers, CA
NPI 1598022071 · NPPES record last updated Nov 11, 2024
Key facts
- NPI
- 1598022071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 76665 (CA)
- Practice address
- 13702 S Cherry Ave
Caruthers, CA 93609-9724 - Phone
- (559) 284-0629
- NPI assigned
- Apr 20, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IR 60221945 | WA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IR 60221945 | WA | |
| Pharmacist | 183500000X | 76665 | CA | Yes |
Addresses
Primary practice location
13702 S Cherry Ave
Caruthers, CA 93609-9724
Mailing address
13702 S Cherry Ave
Caruthers, CA 93609-9724
Phone (559) 284-0629
Other providers in Caruthers, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.