Provider Demographics
NPI:1093739021
Name:YEN, GREG SHIH-HAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:SHIH-HAN
Last Name:YEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1449
Mailing Address - Country:US
Mailing Address - Phone:626-576-8500
Mailing Address - Fax:626-576-8050
Practice Address - Street 1:131 E LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1449
Practice Address - Country:US
Practice Address - Phone:626-576-8500
Practice Address - Fax:626-576-8050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA061210207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A612100Medicaid
CAH65210Medicare UPIN