Provider Demographics
NPI:1659231918
Name:YANEZ, DAVID (CDL)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:YANEZ
Suffix:
Gender:M
Credentials:CDL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 W PECOS RD APT 2062
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7417
Mailing Address - Country:US
Mailing Address - Phone:623-707-6862
Mailing Address - Fax:
Practice Address - Street 1:575 W PECOS RD APT 2062
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7417
Practice Address - Country:US
Practice Address - Phone:623-707-6862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZB13742225343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)