Organization
AMY YETASOOK MD INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY YETASOOK M.D. (PRESIDENT)
(213) 268-5421
Entity
Organization
Contact information
Practice address
1386B W 7TH ST, SAN PEDRO, CA 90732-3517
(213) 268-5421
Mailing address
4220 OCEAN DR, MANHATTAN BEACH, CA 90266-3059
(213) 268-5421
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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