MEDICARE: DR. YUN SZU YEH 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	261QP3300X	Pain Clinic/Center	32323	AZ
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	8342	NV
3	261QP3300X	Pain Clinic/Center	8342	NV
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	32323	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54195	OTHER	NV	LUMENOS
2	21197839677404	OTHER	NV	BEECHSTREET
3	5530696	OTHER	NV	AETNA PIN
4	CC7472	OTHER	NV	BLUE CROSS/ BLUE SHEILD
5	AZ0756700	OTHER	AZ	AZ BLUE SHEILD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	5530696	OTHER	AZ	AETNA PIN
8	2Z1333	OTHER	AZ	HEALTHNET AZ

General Provider Information

NPI Number	:	1962433417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YUN SZU YEH MD

Provider Business Mailing Address
First Line	:	4845 S RAINBOW BLVD STE 401
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4750
Country	:	US
Telephone Number	:	702-644-7246
Fax Number	:	702-384-7246

Provider Business Practice Location Address
First Line	:	4845 S RAINBOW BLVD STE 401
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4750
Country	:	US
Telephone Number	:	702-644-7246
Fax Number	:	702-384-7246

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	03/07/2008

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