Provider Demographics
NPI:1720098445
Name:YUN SZU YEH M.D., INC.
Entity Type:Organization
Organization Name:YUN SZU YEH M.D., INC.
Other - Org Name:PAIN WELLNESS MANAGMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERVISING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT YUN
Authorized Official - Middle Name:SZU
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-871-7243
Mailing Address - Street 1:PO BOX 370654
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0654
Mailing Address - Country:US
Mailing Address - Phone:702-871-7243
Mailing Address - Fax:702-384-7246
Practice Address - Street 1:4845 S RAINBOW BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4916
Practice Address - Country:US
Practice Address - Phone:702-644-7246
Practice Address - Fax:702-384-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8342207LP2900X, 261QP3300X
AZ32323207LP2900X, 261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ373712Medicaid
NVF91331Medicare UPIN
NVV40120Medicare PIN
AZZ83500Medicare PIN