Healthcare Provider Details

I. General information

NPI: 1487688651
Provider Name (Legal Business Name): ROSIE TAN YEO, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 W DUARTE RD
ARCADIA CA
91007-7601
US

IV. Provider business mailing address

PO BOX 5486
ORANGE CA
92863-5486
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-4714
  • Fax:
Mailing address:
  • Phone: 818-550-0900
  • Fax: 818-550-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA32862
License Number StateCA

VIII. Authorized Official

Name: ROSIE TAN YEO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-550-0900