Healthcare Provider Details

I. General information

NPI: 1033156740
Provider Name (Legal Business Name): TONY HUE-DAN YUAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 NORTH JACKSON AVENUE
SAN JOSE CA
94608-1803
US

IV. Provider business mailing address

2100 POWELL STREET STE 920
EMERYVILLE CA
94608-1803
US

V. Phone/Fax

Practice location:
  • Phone: 510-350-2777
  • Fax:
Mailing address:
  • Phone: 510-350-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number9806A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMED-PHYS-LIC-34023
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number9064844-1205
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD2014-0724
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number15481
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDR.0054437
License Number StateCO
# 7
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM-12661
License Number StateID
# 8
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD60476217
License Number StateWA
# 9
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-18004
License Number StateHI
# 10
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD168822
License Number StateOR
# 11
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number49508
License Number StateAZ
# 12
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number281239
License Number StateNY
# 13
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME125239
License Number StateFL
# 14
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD455902
License Number StatePA
# 15
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA65615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: