Provider Demographics
NPI:1578776027
Name:YEUNG-YUE, KIMBERLY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANNE
Last Name:YEUNG-YUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:ANNE
Other - Last Name:YUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10200 N 92ND ST
Mailing Address - Street 2:SUITE #205
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4534
Mailing Address - Country:US
Mailing Address - Phone:602-494-1817
Mailing Address - Fax:480-614-2429
Practice Address - Street 1:10200 N 92ND ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4534
Practice Address - Country:US
Practice Address - Phone:602-494-1817
Practice Address - Fax:480-614-2429
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35998207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ412823Medicaid
AZZ164497Medicare PIN
AZZWMBJQMedicare PIN