Individual
JACK YANAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2021 N 12TH ST, GRAND JUNCTION, CO 81501-2980
(970) 242-0920
Mailing address
2754 COMPASS DR, SUITE 300, GRAND JUNCTION, CO 81506-8714
(970) 254-1686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
27425
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9434132923001
ROCKY MTN HMO
—
05
—
95106278
—
CO
01
—
P00184265
RAILROAD MEDICARE
—
01
—
YA638008
BLUE CROSS
CO
Enumeration date
07/03/2006
Last updated
12/07/2007
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