Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20A15326 | CA |
NPI | 1104263607 |
---|---|
Provider Name | Eric Yuan |
First Address | Palm Desert, CA 92211-2080 |
Second Address | Palm Desert, CA 92211-2080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2013 |
Last Update Date | 28/10/2021 |