Healthcare Provider Details

I. General information

NPI: 1720098445
Provider Name (Legal Business Name): YUN SZU YEH M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 S RAINBOW BLVD SUITE 401
LAS VEGAS NV
89103-4916
US

IV. Provider business mailing address

PO BOX 370654
LAS VEGAS NV
89137-0654
US

V. Phone/Fax

Practice location:
  • Phone: 702-644-7246
  • Fax: 702-384-7246
Mailing address:
  • Phone: 702-871-7243
  • Fax: 702-384-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number8342
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number32323
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number8342
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number32323
License Number StateAZ

VIII. Authorized Official

Name: DR. ALBERT YUN SZU YEH
Title or Position: SUPERVISING PHYSICIAN
Credential: M.D.
Phone: 702-871-7243