Healthcare Provider Details

I. General information

NPI: 1093964587
Provider Name (Legal Business Name): BILL W.B. YEUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CENTERPOINTE DR STE 115
LA PALMA CA
90623-2567
US

IV. Provider business mailing address

26 POINT LOMA DR
CORONA DEL MAR CA
92625-1026
US

V. Phone/Fax

Practice location:
  • Phone: 714-562-8632
  • Fax: 949-706-7861
Mailing address:
  • Phone: 714-562-8632
  • Fax: 949-706-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG27783
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: