Healthcare Provider Details

I. General information

NPI: 1992700280
Provider Name (Legal Business Name): CATHERINE ELEANOR YEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 E CLINTON AVE DEPT OF
FRESNO CA
93703-2223
US

IV. Provider business mailing address

483 W MUNCIE AVE
CLOVIS CA
93619-8351
US

V. Phone/Fax

Practice location:
  • Phone: 559-228-5328
  • Fax:
Mailing address:
  • Phone: 559-299-6283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number00G85819
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG85819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: