Organization
MAZIN K YALDO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAZIN K YALDO MD (PRESIDENT/OWNER)
(313) 278-4540
Entity
Organization
Contact information
Practice address
2810 CAMINO DEL RIO S, SUITE 106, SAN DIEGO, CA 92108-3818
(619) 255-6584
(619) 501-9054
Mailing address
31535 FORD RD, GARDEN CITY, MI 48135-1821
(313) 278-4540
(313) 278-4541
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G70910
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043221187
INDIVIDUAL NPI
MI
01
—
HA945A
MEDICARE PTAN
CA
Enumeration date
02/14/2013
Last updated
05/27/2014
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