Healthcare Provider Details

I. General information

NPI: 1407882889
Provider Name (Legal Business Name): WILLIAM YEP DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2364 GEARY BLVD
SAN FRANCISCO CA
94115-3305
US

IV. Provider business mailing address

555 W BENJAMIN HOLT DR BUILDING B
STOCKTON CA
95207-3839
US

V. Phone/Fax

Practice location:
  • Phone: 415-921-6722
  • Fax: 415-921-6737
Mailing address:
  • Phone: 209-476-4700
  • Fax: 209-478-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number35807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: