Provider Demographics
NPI:1063259273
Name:GARBA, YAHAYA
Entity type:Individual
Prefix:
First Name:YAHAYA
Middle Name:
Last Name:GARBA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 N ASTER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-8889
Mailing Address - Country:US
Mailing Address - Phone:310-491-6309
Mailing Address - Fax:
Practice Address - Street 1:24863 W JAYNE AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9502
Practice Address - Country:US
Practice Address - Phone:559-935-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95311282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse