Provider Demographics
NPI:1609032283
Name:JAMES K. YAN, D.O., MEDICAL OFFICE INC.
Entity type:Organization
Organization Name:JAMES K. YAN, D.O., MEDICAL OFFICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:415-781-1818
Mailing Address - Street 1:728 PACIFIC AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4457
Mailing Address - Country:US
Mailing Address - Phone:415-781-1818
Mailing Address - Fax:
Practice Address - Street 1:728 PACIFIC AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4457
Practice Address - Country:US
Practice Address - Phone:415-781-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-02
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6238207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG50111Medicare UPIN