Healthcare Provider Details

I. General information

NPI: 1225945975
Provider Name (Legal Business Name): DYLAN YEH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 S FAIR OAKS AVE STE 12
PASADENA CA
91105-4130
US

IV. Provider business mailing address

257 S FAIR OAKS AVE STE 120
PASADENA CA
91105-4123
US

V. Phone/Fax

Practice location:
  • Phone: 626-585-1345
  • Fax: 626-585-1625
Mailing address:
  • Phone: 626-585-1345
  • Fax: 626-585-1625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: