Provider Demographics
NPI:1194892703
Name:YUAN, ROBIN TSU-WANG (MD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:TSU-WANG
Last Name:YUAN
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 1:462 N LINDEN DR
Mailing Address - Street 2:SUITE 236
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2247
Mailing Address - Country:US
Mailing Address - Phone:310-385-8425
Mailing Address - Fax:310-385-9423
Practice Address - Street 1:462 N LINDEN DR
Practice Address - Street 2:SUITE 236
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2247
Practice Address - Country:US
Practice Address - Phone:310-385-8425
Practice Address - Fax:310-385-9423
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41276208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG41276Medicare ID - Type Unspecified
CAB56945Medicare UPIN