Provider Demographics
NPI:1215253117
Name:JOSHUA S. YAMAMOTO, M.D., LLC
Entity type:Organization
Organization Name:JOSHUA S. YAMAMOTO, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:SHIGERU
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-235-9524
Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 515
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:240-235-9524
Mailing Address - Fax:240-223-0684
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 515
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:240-235-9524
Practice Address - Fax:240-223-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051320174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty