Provider Demographics
NPI:1265515290
Name:LI, HO- YIN ADRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:HO- YIN
Middle Name:ADRIAN
Last Name:LI
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 1:237 ESTUDILLO AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4725
Mailing Address - Country:US
Mailing Address - Phone:415-316-9382
Mailing Address - Fax:510-315-8715
Practice Address - Street 1:5801 E TAFT RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-3291
Practice Address - Country:US
Practice Address - Phone:315-418-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50572207L00000X, 207LC0200X, 207LP2900X
NY218452207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C505720Medicaid
CA00C505720Medicaid
CACA149363Medicare PIN
CACA149364Medicare PIN
CAP01058586Medicare PIN
CAP01499452Medicare PIN
CA00C505722Medicare PIN
CAZZZ29200ZMedicare PIN
CAEF468XMedicare PIN