MEDICARE: KEVIN YAO MD MPH

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	207R00000X	Internal Medicine Physician	1588306625	CA
2	390200000X	Student in an Organized Health Care Education/Training Program		CA

General Provider Information

NPI Number	:	1588306625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN YAO MD MPH

Provider Business Mailing Address
First Line	:	533 W LAS TUNAS DR UNIT 201
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1133
Country	:	US
Telephone Number	:	626-284-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	533 W LAS TUNAS DR UNIT 201
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1133
Country	:	US
Telephone Number	:	626-284-2000
Fax Number	:

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

Provider Enumeration Date	:	04/09/2022
Last Update Date	:	06/09/2026

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