# MARK K YAMAGUCHI PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pain Consultants of Minnesota
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255730917
- **Authorized official:** MARK KENJI YAMAGUCHI MD (PRESIDENT / OWNER)
- **Authorized official phone:** (612) 455-0612

## Contact information

- **Practice address:** 2020 E 28TH ST, SUITE 100, MINNEAPOLIS, MN 55407-1394
- **Practice address phone:** (612) 455-0612
- **Practice address fax:** (612) 455-0610
- **Mailing address:** 2854 HIGHWAY 55, SUITE 130, EAGAN, MN 55121-2156
- **Mailing address phone:** (612) 455-0612
- **Mailing address fax:** (612) 455-0610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2014
- **Last updated:** 09/12/2014