Healthcare Provider Details

I. General information

NPI: 1548339658
Provider Name (Legal Business Name): JOYCE CHEUK-KWAN YAN D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST PODIATRY, SURGICAL SERVICES
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

2125 EUCLID AVE
PALO ALTO CA
94303-1704
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone: 650-328-1839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE4220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: