Organization
DR. G GARRY YACOUB OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. G GARRY YACOUB OD (OWNER)
(925) 672-4100
Entity
Organization
Contact information
Practice address
1460 WASHINGTON BLVD, A101, CONCORD, CA 94521-4048
(925) 672-4100
Mailing address
1460 WASHINGTON BLVD, A101, CONCORD, CA 94521-4048
(925) 672-4100
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
05621
CA
Other
Enumeration date
04/09/2007
Last updated
01/11/2008
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