Healthcare Provider Details

I. General information

NPI: 1851374631
Provider Name (Legal Business Name): DICK M YIP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICHARD YIP MD

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 S BEACH BLVD
ANAHEIM CA
92804-1853
US

IV. Provider business mailing address

408 S BEACH BLVD STE 211
ANAHEIM CA
92804-1869
US

V. Phone/Fax

Practice location:
  • Phone: 714-527-6000
  • Fax: 714-527-2371
Mailing address:
  • Phone: 714-527-6000
  • Fax: 714-527-2371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG48821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: