Provider Demographics
NPI:1366493033
Name:YEN, RAYMOND SHUEN-YI (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:SHUEN-YI
Last Name:YEN
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 1:55 E CALIFORNIA BLVD
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3954
Mailing Address - Country:US
Mailing Address - Phone:626-793-1227
Mailing Address - Fax:626-793-3794
Practice Address - Street 1:55 E CALIFORNIA BLVD
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3954
Practice Address - Country:US
Practice Address - Phone:626-793-1227
Practice Address - Fax:626-793-3794
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61728207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G617280Medicaid
CAF12790Medicare UPIN
CAWG61728HMedicare ID - Type Unspecified