Provider Demographics
NPI:1710556899
Name:YUEN NEUROPEDIATRICS INC.
Entity Type:Organization
Organization Name:YUEN NEUROPEDIATRICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-227-8136
Mailing Address - Street 1:2216 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-264-2100
Mailing Address - Fax:310-264-2108
Practice Address - Street 1:2216 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-264-2100
Practice Address - Fax:310-264-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty