Provider Demographics
NPI:1235186354
Name:YEON, CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:YEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:626-775-3514
Mailing Address - Fax:626-408-3911
Practice Address - Street 1:209 FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-1814
Practice Address - Country:US
Practice Address - Phone:626-396-2900
Practice Address - Fax:626-799-2889
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA72171207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA72171DMedicare ID - Type Unspecified
CA108191Medicare UPIN