Basic Information
Provider Information
NPI: 1174813943
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOURMAN
FirstName: LINDSEY
MiddleName: C.
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 232410
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921932410
CountryCode: US
TelephoneNumber: 8582496751
FaxNumber:  
Practice Location
Address1: 200 W ARBOR DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921039000
CountryCode: US
TelephoneNumber: 8582492500
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/14/2011
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0300XA122839CAY Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine

No ID Information.


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