Provider Demographics
NPI:1447499710
Name:YAN, MIN (MD)
Entity type:Individual
Prefix:
First Name:MIN
Middle Name:
Last Name:YAN
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 1:4721 DALLAS RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8811
Mailing Address - Country:US
Mailing Address - Phone:925-778-0679
Mailing Address - Fax:925-778-3567
Practice Address - Street 1:2633 TELEGRAPH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1743
Practice Address - Country:US
Practice Address - Phone:510-830-3100
Practice Address - Fax:925-778-3567
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA115562207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine