Provider Demographics
NPI:1811055874
Name:YEH, TOM THAO (MD)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:THAO
Last Name:YEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:THONG
Other - Middle Name:PHANH
Other - Last Name:THAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7837 GARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3013
Mailing Address - Country:US
Mailing Address - Phone:626-572-3100
Mailing Address - Fax:626-572-9584
Practice Address - Street 1:7837 GARVEY AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3013
Practice Address - Country:US
Practice Address - Phone:626-572-3100
Practice Address - Fax:626-572-9584
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38144207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A381440Medicaid
CAA38144Medicare ID - Type Unspecified
CA00A381440Medicaid