Provider Demographics
NPI:1265458228
Name:YE, JIAN N (MD)
Entity Type:Individual
Prefix:DR
First Name:JIAN
Middle Name:N
Last Name:YE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 N GARFIELD AVE
Mailing Address - Street 2:SUITE 110A
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1242
Mailing Address - Country:US
Mailing Address - Phone:626-288-4840
Mailing Address - Fax:626-288-4820
Practice Address - Street 1:500 N GARFIELD AVE
Practice Address - Street 2:SUITE 110A
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:626-288-4840
Practice Address - Fax:626-288-4820
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA063361207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A633610OtherBLUE SHIELD
CA00A633610Medicaid
CA00A633610OtherBLUE SHIELD
CAWA63361AMedicare PIN