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Individual

KAI GABRIEL GENUNG YAMAMOTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
2501 CHERRY AVE, STE 250, SIGNAL HILL, CA 90755-2041
(714) 640-4469
Mailing address
13372 CROMWELL DR, TUSTIN, CA 92780-4704
(714) 640-4469

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19622
CA

Other

Enumeration date
02/25/2019
Last updated
12/27/2021
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