Provider Demographics
NPI:1568723856
Name:YIN, ALLAN J T (M D)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:J T
Last Name:YIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 SKYLARK CIR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4844
Mailing Address - Country:US
Mailing Address - Phone:714-546-6274
Mailing Address - Fax:
Practice Address - Street 1:2717 SKYLARK CIR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4844
Practice Address - Country:US
Practice Address - Phone:714-546-6274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG13309208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice