Provider Demographics
NPI:1598758690
Name:YAO, STEPHANIE S (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:YAO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:72780 COUNTRY CLUB DR
Mailing Address - Street 2:#100
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4126
Mailing Address - Country:US
Mailing Address - Phone:760-773-9750
Mailing Address - Fax:760-773-9750
Practice Address - Street 1:72780 COUNTRY CLUB DR
Practice Address - Street 2:#100
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4126
Practice Address - Country:US
Practice Address - Phone:760-773-9750
Practice Address - Fax:760-773-9750
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2021-12-06
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Provider Licenses
StateLicense IDTaxonomies
CAC52376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095200Medicaid
ILG60171Medicare UPIN
IL036095200Medicaid