Provider Demographics
NPI:1992781884
Name:YEN, ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
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 1:10535 HOSPITAL WAY
Mailing Address - Street 2:111/G, DIVISION OF GASTROENTEROLOGY
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655
Mailing Address - Country:US
Mailing Address - Phone:916-366-5339
Mailing Address - Fax:
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:111/G, DIVISION OF GASTROENTEROLOGY
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655
Practice Address - Country:US
Practice Address - Phone:916-366-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92631207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine