Provider Demographics
NPI:1972336659
Name:YEO, GAIK IMM
Entity type:Individual
Prefix:
First Name:GAIK
Middle Name:IMM
Last Name:YEO
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 1:3764 TILDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6912
Mailing Address - Country:US
Mailing Address - Phone:310-447-4545
Mailing Address - Fax:
Practice Address - Street 1:3764 TILDEN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-6912
Practice Address - Country:US
Practice Address - Phone:310-447-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker