MEDICARE: NORMA YUEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	936451	CA
2	1223E0200X	Endodontics	936451	CA
3	1223G0001X	General Practice Dentistry	936451	CA
4	1223P0106X	Oral and Maxillofacial Pathology Dentistry	936451	CA
5	1223P0221X	Pediatric Dentistry	936451	CA
6	1223P0300X	Periodontics	936451	CA
7	1223P0700X	Prosthodontics	936451	CA
8	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	936451	CA
9	1223X0008X	Oral and Maxillofacial Radiology Dentistry	936451	CA
10	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	936451	CA
11	122400000X	Denturist	936451	CA

General Provider Information

NPI Number	:	1003004888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA YUEN DDS

Provider Business Mailing Address
First Line	:	PO BOX 122223
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91912-6923
Country	:	US
Telephone Number	:	619-454-4342
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEFENSORES DE BAJA CALIFORNIA #702
Second Line	:	COLONIA RUIZ CORTINEZ
City	:	TIJUANA
State	:	BAJA CALIFORNIA
Zip	:	22350
Country	:	MX
Telephone Number	:	526646825234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	02/03/2010

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Directions to “ NORMA YUEN DDS” Practice Location

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