Healthcare Provider Details

I. General information

NPI: 1275853608
Provider Name (Legal Business Name): KRISTINE KAY YIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 02/15/2020
Certification Date: 02/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

475 W BADILLO ST
COVINA CA
91723-1834
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-2450
  • Fax:
Mailing address:
  • Phone: 626-732-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA125816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: