Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 20A7810 | CA |
NPI | 1033153101 |
---|---|
Provider Name | Dr. Malvin Yan |
First Address | South Gate, CA 90280-5219 |
Second Address | South Gate, CA 90280-5219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 30/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I22170 | (02) | CA |