Provider Demographics
NPI:1104453091
Name:YUCEL, MAHMUT GENCO (MD)
Entity type:Individual
Prefix:MR
First Name:MAHMUT
Middle Name:GENCO
Last Name:YUCEL
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 1:1515 UNION ST UNIT 2A
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4581
Mailing Address - Country:US
Mailing Address - Phone:510-631-3252
Mailing Address - Fax:
Practice Address - Street 1:1515 UNION ST UNIT 2A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4581
Practice Address - Country:US
Practice Address - Phone:510-631-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ2029123759207RC0000X, 207RI0011X
IL036.159779207RC0000X, 207RI0011X
ORMD218938207RI0011X
NMMD2024-1050207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease