Individual
NICHOLAS CORNELL YARU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1441 AVOCADO AVE, SUITE 802, NEWPORT BEACH, CA 92660-7721
(949) 644-9000
(949) 644-9330
Mailing address
1441 AVOCADO AVE, SUITE 802, NEWPORT BEACH, CA 92660-7721
(949) 644-9000
(949) 644-9330
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G47315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G473150
—
CA
01
—
200004146
MEDICARE RAILROAD
—
01
—
6500090001
PROVIDER TRANSACTION ACCESS NUMBER, NSC SUPPLIER NUMBER
CA
01
—
G47315
MEDICARE ID
CA
Enumeration date
11/17/2006
Last updated
05/17/2013
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