Provider Demographics
NPI:1326227232
Name:YEN, MAY JIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MAY
Middle Name:JIM
Last Name:YEN
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 1:833 AMERICANA WAY
Mailing Address - Street 2:UNIT 225
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91210-1529
Mailing Address - Country:US
Mailing Address - Phone:213-255-5231
Mailing Address - Fax:
Practice Address - Street 1:413 S CENTRAL AVE
Practice Address - Street 2:SUITE A153
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1640
Practice Address - Country:US
Practice Address - Phone:213-255-5231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102911207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACW939WMedicare PIN