MEDICARE: YVONNE TYSON MD

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	207Q00000X	Family Medicine Physician	G48985	CA

General Provider Information

NPI Number	:	1881617868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE TYSON MD

Provider Business Mailing Address
First Line	:	3816 WOODRUFF AVE STE 412
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2146
Country	:	US
Telephone Number	:	562-377-1111
Fax Number	:	562-394-9277

Provider Business Practice Location Address
First Line	:	3816 WOODRUFF AVE STE 412
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2146
Country	:	US
Telephone Number	:	562-377-1111
Fax Number	:	562-394-9277

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	05/02/2022

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Directions to “ YVONNE TYSON MD” Practice Location

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