Kentaro E Yamada M.D. Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

KENTARO E YAMADA M.D. INC

Practice address

1040 University Ave Ste B209A
San Diego, CA 92103-7328

Phone

(619) 299-1100

Fax

(619) 299-7156

NPI assigned

Sep 20, 2006

Last updated

Mar 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kentaro E Yamada, M.D.NPI 1629047188

Title

President

Phone

(619) 299-1100

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kentaro Emil Yamada, MD

  • Ophthalmology Physician
  • San Diego, CA
  • NPI 1629047188
  Medicare reassignment NPD Authorized official
• Maryam Mehrzad, OD

  • Optometrist
  • San Diego, CA
  • NPI 1891382495
  NPD (past)
• Mark Evan Warlen, MD

  • Ophthalmology Physician
  • San Diego, CA
  • NPI 1518922178
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1730287327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 UNIVERSITY AVE STE B209A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921037328",
            "telephone_number": "161-929-9110",
            "fax_number": "619-299-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 UNIVERSITY AVE STE B209A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921037328",
            "telephone_number": "619-299-1100",
            "fax_number": "619-299-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTARO E YAMADA M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "YAMADA",
        "authorized_official_first_name": "KENTARO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-299-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A953870",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PPIN",
            "identifier": "WA95387A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Alexander Kent, CNM
• Madison Kent, MD
• Michael Lewis Kent, MD
• Tania Kent
• William Kent, M.D.
• Rebecca J Kenyon, PSY.D., MFT
• Kyle Kenzy
• Chanda Keo-Deguzman
• Sinath Janiece Keo
• Louise H. Keogh, MD

• Ophthalmology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.