Most Relevant Information
Provider Data
| NPI Number: | 1003041161 |
| Provider Name: | SUSAN KERMOIAN YASZAY NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 519882 |
Most Important Dates
| Enumeration Date: | 05/19/2009 |
| Last Updated: | 05/19/2009 |
Provider Practice Location
823 GATEWAY CENTER WAY
SAN DIEGO
CA
921024541
Practice Location Phone/Fax
| Phone: | 6195152300 |
| Fax: | 6192321360 |
Provider Mailing Location
823 GATEWAY CENTER WAY
SAN DIEGO
CA
921024541
Provider Mailing Phone/Fax
| Phone: | 6195152300 |
| Fax: | 6192321360 |