Provider Demographics
NPI:1760419238
Name:DANA K. WONG YUEN, M.D., A PROFESSIONAL MEDICAL CORP.
Entity Type:Organization
Organization Name:DANA K. WONG YUEN, M.D., A PROFESSIONAL MEDICAL CORP.
Other - Org Name:EUREKA CHRISTIAN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-232-5651
Mailing Address - Street 1:300 N GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-2460
Mailing Address - Country:US
Mailing Address - Phone:626-570-8664
Mailing Address - Fax:626-570-8494
Practice Address - Street 1:300 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-2460
Practice Address - Country:US
Practice Address - Phone:626-570-8664
Practice Address - Fax:626-570-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53099207W00000X
CANP 7134363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty