Provider Demographics
NPI:1598944712
Name:DAVID D. YEH, MD, INC
Entity Type:Organization
Organization Name:DAVID D. YEH, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-358-0133
Mailing Address - Street 1:2505 SAMAMRITAN DRIVE
Mailing Address - Street 2:SUITE 605
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4017
Mailing Address - Country:US
Mailing Address - Phone:408-358-0133
Mailing Address - Fax:408-358-8134
Practice Address - Street 1:2505 SAMAMRITAN DRIVE
Practice Address - Street 2:SUITE 605
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4017
Practice Address - Country:US
Practice Address - Phone:408-358-0133
Practice Address - Fax:408-358-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94144174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA94144Medicare UPIN