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General NPI Number Information
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NPI Number | 1487862066
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Entity Type | Individual
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Provider Name | JASON STEPHEN YIP M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 408 S BEACH BLVD STE 211
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City | ANAHEIM
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State | CA
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Zip | 92804-1869
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Country | US
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Telephone | 714-527-6000
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Fax | 714-527-2371
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Provider Business Mailing Address
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Address Line | 408 S BEACH BLVD STE 211
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City | ANAHEIM
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State | CA
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Zip | 92804-1869
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Country | US
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Telephone | 714-527-6000
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Fax | 714-527-2371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A120176
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License Number State | CA
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