Provider Demographics
NPI:1598784738
Name:YEN, HELEN H (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:H
Last Name:YEN
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 1:2219 W OLIVE AVE
Mailing Address - Street 2:#219
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2625
Mailing Address - Country:US
Mailing Address - Phone:760-351-3432
Mailing Address - Fax:760-351-3702
Practice Address - Street 1:207 W LEGION RD
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7780
Practice Address - Country:US
Practice Address - Phone:760-351-3432
Practice Address - Fax:760-351-3702
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55832207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A558320Medicaid
CALAB44024FMedicaid
ZZZ58613ZOtherMEDICARE GROUP PTAN
CAA55832OtherSTATE LICENSE #
AX995YOtherMEDICARE PTAN
CA00A558320Medicaid