Provider Demographics
NPI:1306959135
Name:CHEN, YAKUAN YVONNE (MD)
Entity type:Individual
Prefix:
First Name:YAKUAN YVONNE
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3300 WEBSTER ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3117
Mailing Address - Country:US
Mailing Address - Phone:510-451-0996
Mailing Address - Fax:510-451-0410
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:SUITE 304
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-451-0996
Practice Address - Fax:510-451-0410
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70467174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A704670Medicaid
CA00A704671Medicare ID - Type Unspecified
CA00A704670Medicaid