MEDICARE: DAVID J YEH MMD

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	207T00000X	Neurological Surgery Physician	MD40688	TN
2	207T00000X	Neurological Surgery Physician	R5058	TX
3	207T00000X	Neurological Surgery Physician	M-2439	GU
4	207T00000X	Neurological Surgery Physician	20326	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00691498	OTHER	MS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	TN01X7	OTHER	TN	JOHN DEERE
4	7865604	OTHER	MS	AETNA
5	4115908	OTHER	TN	BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720044415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J YEH MMD

Provider Business Mailing Address
First Line	:	1531 HIGUERA ST
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-2917
Country	:	US
Telephone Number	:	805-704-0889
Fax Number	:	805-548-1994

Provider Business Practice Location Address
First Line	:	1531 HIGUERA ST
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-2917
Country	:	US
Telephone Number	:	805-704-0889
Fax Number	:	805-548-1994

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

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	08/08/2024

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Directions to “ DAVID J YEH MMD” Practice Location

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