Individual
ERIC K YASUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
999 S FAIRMONT AVE, # 110, LODI, CA 95240-5100
(209) 334-4416
(209) 371-0119
Mailing address
5222 COSUMNES DR APT 272, STOCKTON, CA 95219-7221
(216) 337-8582
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A70070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A700700
—
CA
Enumeration date
02/28/2007
Last updated
04/24/2008
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