Healthcare Provider Details

I. General information

NPI: 1912088162
Provider Name (Legal Business Name): FELIX CHI-MING YIP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N GARFIELD AVE STE 308
MONTEREY PARK CA
91754-1169
US

IV. Provider business mailing address

600 N GARFIELD AVE STE 308
MONTEREY PARK CA
91754-1169
US

V. Phone/Fax

Practice location:
  • Phone: 626-288-0889
  • Fax: 626-288-1129
Mailing address:
  • Phone: 626-288-0889
  • Fax: 626-288-1129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberG46406
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberG46406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: