Provider Demographics
NPI:1891847380
Name:YAP-KATZMAN, FAYE PHOEBE (OD)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:PHOEBE
Last Name:YAP-KATZMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:FAYE
Other - Middle Name:PHOEBE
Other - Last Name:YAP-JIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:228 ROSILIE ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4906
Mailing Address - Country:US
Mailing Address - Phone:650-867-3733
Mailing Address - Fax:
Practice Address - Street 1:390 EL CAMINO REAL
Practice Address - Street 2:SUITE J
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-2054
Practice Address - Country:US
Practice Address - Phone:650-867-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10959T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU67266Medicare UPIN
CASDO109590Medicare ID - Type Unspecified