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Individual

BRYCE KIYOSHI YAMAUCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1300 W 155TH ST, #210, GARDENA, CA 90247-4061
(310) 767-1538
(310) 767-1165
Mailing address
1300 W 155TH ST, #210, GARDENA, CA 90247-4061
(310) 767-1538
(310) 767-1165

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3477
CA
213E00000X
Podiatrist
PO104
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E34772
CA
Enumeration date
08/17/2006
Last updated
02/24/2011
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