Healthcare Provider Details

I. General information

NPI: 1104276286
Provider Name (Legal Business Name): BRIAN YI D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HUNTINGTON DR
ARCADIA CA
91007-3402
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 626-574-3540
  • Fax:
Mailing address:
  • Phone: 626-574-3540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A15949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: