Provider Demographics
NPI:1073633541
Name:JAMES K. YEO, M.D., INC.
Entity Type:Organization
Organization Name:JAMES K. YEO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:YEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-962-6694
Mailing Address - Street 1:1433 W MERCED AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3402
Mailing Address - Country:US
Mailing Address - Phone:626-962-6694
Mailing Address - Fax:626-962-1694
Practice Address - Street 1:1433 W MERCED AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3402
Practice Address - Country:US
Practice Address - Phone:626-962-6694
Practice Address - Fax:626-962-1694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA19778208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A1977A0Medicaid
CA00A1977A0Medicaid
CAA19778Medicare ID - Type Unspecified