Provider Demographics
NPI:1326050071
Name:ALICE YAN, MD, INCORPORATED
Entity Type:Organization
Organization Name:ALICE YAN, MD, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:LIM
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-991-4466
Mailing Address - Street 1:1500 SOUTHGATE AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2205
Mailing Address - Country:US
Mailing Address - Phone:650-991-4466
Mailing Address - Fax:650-991-4467
Practice Address - Street 1:1500 SOUTHGATE AVE STE 115
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2205
Practice Address - Country:US
Practice Address - Phone:650-991-4466
Practice Address - Fax:650-991-4467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty