Healthcare Provider Details
I. General information
NPI: 1699166702
Provider Name (Legal Business Name): WOON TECK YAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/11/2015
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 PARNASSUS AVE FL 3
SAN FRANCISCO CA
94143-2204
US
IV. Provider business mailing address
200 W ARBOR DR
SAN DIEGO CA
92103-9000
US
V. Phone/Fax
- Phone: 415-353-1968
- Fax:
- Phone:
- Fax: 617-344-3193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | A152654 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | A152654 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 330656 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: