Individual
CHERYL YAMAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20165 N 67TH AVE STE 107, GLENDALE, AZ 85308-7004
(623) 561-1590
(623) 561-0534
Mailing address
3156 W MONTE CRISTO AVE, PHOENIX, AZ 85053-3936
(310) 200-7654
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3565
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81571828
—
AZ
Enumeration date
10/17/2005
Last updated
10/26/2010
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