Healthcare Provider Details

I. General information

NPI: 1295036721
Provider Name (Legal Business Name): TIMOTHY GUAN-TYNG YEH M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 W ROMNEYA DR SUITE NUMBER A
ANAHEIM CA
92801-1815
US

IV. Provider business mailing address

2620 SARATOGA DR
FULLERTON CA
92835-4212
US

V. Phone/Fax

Practice location:
  • Phone: 714-956-4958
  • Fax: 714-400-0488
Mailing address:
  • Phone: 949-378-2882
  • Fax: 714-400-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberG81650
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY G YEH
Title or Position: OWNER
Credential: M.D.
Phone: 714-956-4958