Provider Demographics
NPI:1821472549
Name:YI, PAUL (DPT)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:YI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 402 BOX 1067
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-0011
Mailing Address - Country:US
Mailing Address - Phone:314-590-8992
Mailing Address - Fax:
Practice Address - Street 1:LRMC
Practice Address - Street 2:UNIT 33100
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:314-590-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423804Y5FMedicare PIN