Healthcare Provider Details

I. General information

NPI: 1386825966
Provider Name (Legal Business Name): MING-YI YEN M D A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2007
Last Update Date: 11/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16415 COLORADO AVE STE 301
PARAMOUNT CA
90723-5035
US

IV. Provider business mailing address

16415 COLORADO AVE STE 301
PARAMOUNT CA
90723-5035
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-2512
  • Fax: 562-633-0300
Mailing address:
  • Phone: 562-633-2512
  • Fax: 562-633-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA35926
License Number StateCA

VIII. Authorized Official

Name: DR. MING-YI YEN
Title or Position: OWNER
Credential: M.D.
Phone: 562-633-2512