| Tiffany Yumi Yanase Park, OD | |
|
11370 Anderson St Ste 1800, Loma Linda, CA 92354-3450 | |
| (909) 558-2154 | |
| (909) 558-2180 |
| Full Name | Tiffany Yumi Yanase Park |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 11370 Anderson St Ste 1800, Loma Linda, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194212894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 0003393 (Colorado) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | 0003393 (Colorado) | Secondary |
| 152W00000X | Optometrist | 34091 (California) | Primary |
| Provider Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
| Provider Name | Marshall B Ketchum University |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1720101876 PECOS PAC ID: 9739075177 Enrollment ID: O20040224000463 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Yumi Yanase Park, OD 11370 Anderson St Ste 1800, Loma Linda, CA 92354-3450 Ph: (909) 558-2154 | Tiffany Yumi Yanase Park, OD 11370 Anderson St Ste 1800, Loma Linda, CA 92354-3450 Ph: (909) 558-2154 |
Dr. Douglas Soderblom, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 25815 Barton Rd, Suite 104, Loma Linda, CA 92354 Phone: 909-478-3345 Fax: 909-478-9337 | |
Faculty Physicians And Surgeons Of Llusm Optometrist Medicare: Not Enrolled in Medicare Practice Location: 11370 Anderson St Ste 1800, Loma Linda, CA 92354 Phone: 909-558-2180 | |
Dr. William H Kiernan, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St Ste 1800, Loma Linda, CA 92354 Phone: 909-558-2154 Fax: 909-558-2180 | |
Annessa Du, O.d., A Professional Corporation Optometrist Medicare: Medicare Enrolled Practice Location: 11346 Mountain View Ave Ste B, Loma Linda, CA 92354 Phone: 909-796-0101 | |
Nadiya Shalin Thomas, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St Ste 1800, Loma Linda, CA 92354 Phone: 909-558-2154 | |
Annessa Du, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 11346 Mountain View Ave Ste B, Loma Linda, CA 92354 Phone: 909-796-0101 |