Provider Demographics
NPI:1992463723
Name:YATSU, CRAIG (CPO)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:YATSU
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 NORFOLK ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9343
Mailing Address - Country:US
Mailing Address - Phone:303-400-8866
Mailing Address - Fax:
Practice Address - Street 1:386 NORFOLK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9343
Practice Address - Country:US
Practice Address - Phone:303-400-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCPO03192222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist