Provider Demographics
NPI:1558359125
Name:NG, YEN YEN (OD)
Entity Type:Individual
Prefix:DR
First Name:YEN YEN
Middle Name:
Last Name:NG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:YEN YEN
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:220 N MCKEMY AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2654
Mailing Address - Country:US
Mailing Address - Phone:480-961-1865
Mailing Address - Fax:480-961-4605
Practice Address - Street 1:5846 E MCKELLIPS RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-2796
Practice Address - Country:US
Practice Address - Phone:480-396-3653
Practice Address - Fax:480-396-0273
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ968152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU77819Medicare UPIN
AZZ24853Medicare PIN