Provider Demographics
NPI:1720015944
Name:YEEND, GREGORY D (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:YEEND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72650 FRED WARING DR STE 110B
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5008
Mailing Address - Country:US
Mailing Address - Phone:760-346-5660
Mailing Address - Fax:760-346-5640
Practice Address - Street 1:72650 FRED WARING DR STE 110B
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5008
Practice Address - Country:US
Practice Address - Phone:760-346-5660
Practice Address - Fax:760-346-5640
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU11111Medicare UPIN