Provider Demographics
NPI:1275591463
Name:YEH, TIMOTHY G (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:G
Last Name:YEH
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:PO BOX 5256
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92838-0256
Mailing Address - Country:US
Mailing Address - Phone:714-255-2998
Mailing Address - Fax:714-255-0878
Practice Address - Street 1:1751 W ROMNEYA DR STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1815
Practice Address - Country:US
Practice Address - Phone:714-956-4958
Practice Address - Fax:714-400-0488
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-01-26
Deactivation Date:2024-01-23
Deactivation Code:
Reactivation Date:2024-01-26
Provider Licenses
StateLicense IDTaxonomies
CAG81650174400000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG81650Medicare ID - Type Unspecified
CAH11016Medicare UPIN