MEDICARE: GEOFFREY ALAN YEO O.D.

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	152W00000X	Optometrist	CA12021T	CA

General Provider Information

NPI Number	:	1730230400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEOFFREY ALAN YEO O.D.

Provider Business Mailing Address
First Line	:	192 FOX HILLS MALL
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6402
Country	:	US
Telephone Number	:	310-390-2142
Fax Number	:	310-397-5306

Provider Business Practice Location Address
First Line	:	192 FOX HILLS MALL
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6402
Country	:	US
Telephone Number	:	310-390-2142
Fax Number	:	310-397-5306

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	12/01/2021

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