Individual provider Active NPI

Gina P Yamsuan

  • Specialist
  • Fremont, CA
National Provider Identifier
1689985236
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0079820 Issued in CA
Practice address
2296 Country Dr
Fremont, CA 94536-5315
Phone
(510) 608-3733
Fax
(510) 797-7205
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0079820 CA Primary

Addresses

Primary practice location

2296 Country Dr
Fremont, CA 94536-5315

Mailing address

2296 Country Dr
Fremont, CA 94536-5315
Phone (510) 608-3733

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

LicenseStateTypeSpecialty
0079820CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1689985236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2296 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365315",
            "telephone_number": "510-608-3733",
            "fax_number": "510-797-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365315",
            "telephone_number": "510-608-3733",
            "fax_number": "510-797-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMSUAN",
        "first_name": "GINA",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "0079820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.