Provider Demographics
NPI:1225209117
Name:YENLI MEDICAL CENTER
Entity Type:Organization
Organization Name:YENLI MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILLYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-503-6703
Mailing Address - Street 1:15751 BROOKHURST ST STE 118
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7567
Mailing Address - Country:US
Mailing Address - Phone:714-775-8728
Mailing Address - Fax:714-775-2194
Practice Address - Street 1:15751 BROOKHURST ST STE 118
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7567
Practice Address - Country:US
Practice Address - Phone:714-775-8728
Practice Address - Fax:714-775-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63837207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF56430Medicare UPIN