MEDICARE: DR. DONALD YUEN SZE D.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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	40738	CA

General Provider Information

NPI Number	:	1972509685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD YUEN SZE D.M.D.

Provider Business Mailing Address
First Line	:	11301 WILSHIRE BLVD # W160
Second Line	:	BLDG 500, GROUND FLOOR, DENTAL CLINIC
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-268-3264
Fax Number	:	310-268-3941

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD # W160
Second Line	:	BLDG 500, GROUND FLOOR, DENTAL CLINIC
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-268-3264
Fax Number	:	310-268-3941

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	07/10/2007

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