Provider Demographics
NPI:1841398674
Name:YOUNG, YILI ZHEN (OD)
Entity Type:Individual
Prefix:
First Name:YILI
Middle Name:ZHEN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:YILI
Other - Middle Name:
Other - Last Name:ZHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:908 E SANTA INEZ AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-1821
Mailing Address - Country:US
Mailing Address - Phone:415-215-8809
Mailing Address - Fax:
Practice Address - Street 1:214 S B ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4018
Practice Address - Country:US
Practice Address - Phone:650-343-2080
Practice Address - Fax:650-343-2049
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13175152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist