Basic Information
| Provider Information | |||||||||
| NPI: | 1417012691 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YISHAK | ||||||||
| FirstName: | AKLILU | ||||||||
| MiddleName: | ASHIGRIE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 E JEFFERSON ST | ||||||||
| Address2: | KAISER PERMANENTE MEDICARE ENROLLMENT | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018162424 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8008 WESTPARK DR | ||||||||
| Address2: | KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER | ||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221023109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032876400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD34027 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 0101233842 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.