Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E3286 | CA |
NPI | 1003234022 |
---|---|
Provider Name | Dr. Keith Yuen |
First Address | South Pasadena, CA 91030-4601 |
Second Address | South Pasadena, CA 91030-4601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 07/04/2014 |