MEDICARE: DR. GREG SHIH-HAN YEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	A061210	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093739021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREG SHIH-HAN YEN M.D.

Provider Business Mailing Address
First Line	:	131 E LAS TUNAS DR
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1449
Country	:	US
Telephone Number	:	626-576-8500
Fax Number	:	626-576-8050

Provider Business Practice Location Address
First Line	:	131 E LAS TUNAS DR
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1449
Country	:	US
Telephone Number	:	626-576-8500
Fax Number	:	626-576-8050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/03/2024

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