Provider Demographics
NPI:1366477606
Name:YEH, SANDRA T (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:T
Last Name:YEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 N WINCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1524
Mailing Address - Country:US
Mailing Address - Phone:408-246-8900
Mailing Address - Fax:408-246-8980
Practice Address - Street 1:706 N WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1524
Practice Address - Country:US
Practice Address - Phone:408-246-8900
Practice Address - Fax:408-246-8980
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82081207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A820810Medicare ID - Type Unspecified
H98697Medicare UPIN