Provider Demographics
NPI:1114025228
Name:YEO, JAMES K (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:K
Last Name:YEO
Suffix:
Gender:M
Credentials:MD
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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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA19778208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A197780Medicaid
CA00A197780Medicaid
A19778Medicare ID - Type Unspecified