Healthcare Provider Details

I. General information

NPI: 1649313370
Provider Name (Legal Business Name): DENNIS YICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 OLIVE VIEW DR DEPARTMENT OF MEDICINE 2B-182
SYLMAR CA
91342-1437
US

IV. Provider business mailing address

14445 OLIVE VIEW DR DEPARTMENT OF MEDICINE 2B-182
SYLMAR CA
91342-1437
US

V. Phone/Fax

Practice location:
  • Phone: 818-364-3205
  • Fax:
Mailing address:
  • Phone: 818-364-3205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG079385
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG079385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: