Provider Demographics
NPI:1902821390
Name:YI, JOSEPH C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:YI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 WEST OLYMPIC BLVD
Mailing Address - Street 2:UNIT 516
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015
Mailing Address - Country:US
Mailing Address - Phone:412-657-8550
Mailing Address - Fax:
Practice Address - Street 1:5757 WILSHIRE BLVD STE 376
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3683
Practice Address - Country:US
Practice Address - Phone:323-935-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94478207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A944780Medicaid
CA00A944780Medicaid
CACZ048AMedicare PIN