Provider Demographics
NPI:1114941598
Name:YEDLIN, STEVEN T (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:T
Last Name:YEDLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6056 OCEAN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1845
Mailing Address - Country:US
Mailing Address - Phone:510-547-3521
Mailing Address - Fax:
Practice Address - Street 1:3100 TELEGRAPH AVE
Practice Address - Street 2:2ND FLOOR BAYSIDE MEDICAL GROUP
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3210
Practice Address - Country:US
Practice Address - Phone:510-452-5231
Practice Address - Fax:510-889-8392
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG602142086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB48831Medicare UPIN