Provider Demographics
NPI:1194878512
Name:ROBERTO, LAURO YAP (MD)
Entity type:Individual
Prefix:DR
First Name:LAURO
Middle Name:YAP
Last Name:ROBERTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7471 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2457
Mailing Address - Country:US
Mailing Address - Phone:559-436-4500
Mailing Address - Fax:559-261-1526
Practice Address - Street 1:7471 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2457
Practice Address - Country:US
Practice Address - Phone:559-436-4500
Practice Address - Fax:559-261-1526
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0494212080P0214X
CAA49421207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A494210OtherRENDERING PROVIDER NUMBER
ZZZ21572ZOtherGROUP PTAN
770208441OtherGROUP TAX ID
CAGR0043790Medicaid