Provider Demographics
NPI:1285098707
Name:YUNG, MADELINE
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:YUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVENUE, BLDG. 5, 4M
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110
Mailing Address - Country:US
Mailing Address - Phone:628-206-8304
Mailing Address - Fax:415-206-6122
Practice Address - Street 1:1001 POTRERO AVENUE, BLDG. 5, 4M
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:628-206-8304
Practice Address - Fax:415-206-6122
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
CAA152481207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No282N00000XHospitalsGeneral Acute Care Hospital