Provider Demographics
NPI:1679660088
Name:YEH, TIMOTHY L H (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:L H
Last Name:YEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E MARCH LN STE D460
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-6629
Mailing Address - Country:US
Mailing Address - Phone:209-472-2300
Mailing Address - Fax:209-472-2446
Practice Address - Street 1:1801 E MARCH LN STE D460
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-6629
Practice Address - Country:US
Practice Address - Phone:209-472-2300
Practice Address - Fax:209-472-2446
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG299750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G299750Medicaid
CA00G299750Medicaid
CAA44245Medicare UPIN