Provider Demographics
NPI:1609405059
Name:YAN, ARTHUR (DO)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:YAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 A ST UNIT 10
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-1755
Mailing Address - Country:US
Mailing Address - Phone:248-935-9793
Mailing Address - Fax:
Practice Address - Street 1:2146 ENCINITAS BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4371
Practice Address - Country:US
Practice Address - Phone:760-790-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A23880208100000X
PAOT023211208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1223452197Medicaid