Provider Demographics
NPI:1740258003
Name:YEN, ELIZABETH HECHAVARRIA (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HECHAVARRIA
Last Name:YEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:HECHAVARRIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:500 PAMASSUS AVE, MU-4E BOX 0136
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0136
Mailing Address - Country:US
Mailing Address - Phone:415-476-5892
Mailing Address - Fax:415-476-1343
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0110
Practice Address - Country:US
Practice Address - Phone:415-476-5892
Practice Address - Fax:415-476-1343
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220343208000000X, 2080P0206X
CAC551082080P0206X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
A3680101Medicare UPIN