Provider Demographics
NPI:1962572925
Name:YAGHMAI, CYRUS (MD)
Entity type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:
Last Name:YAGHMAI
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 1:23559 MARIANO ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4143
Mailing Address - Country:US
Mailing Address - Phone:760-774-6579
Mailing Address - Fax:
Practice Address - Street 1:250 N 1ST ST
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225
Practice Address - Country:US
Practice Address - Phone:760-774-6579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56287207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA219913Medicare PIN
CA00A562870Medicare PIN
CACA165090Medicare PIN
CAP01617210Medicare PIN
CACA219914Medicare PIN
CACA122206Medicare PIN