Basic Information
Provider Information
NPI: 1003004888
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YUEN
FirstName: NORMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 122223
Address2:  
City: CHULA VISTA
State: CA
PostalCode: 919126923
CountryCode: US
TelephoneNumber: 6194544342
FaxNumber:  
Practice Location
Address1: DEFENSORES DE BAJA CALIFORNIA #702
Address2: COLONIA RUIZ CORTINEZ
City: TIJUANA
State: BAJA CALIFORNIA
PostalCode: 22350
CountryCode: MX
TelephoneNumber: 526646825234
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/05/2007
LastUpdateDate: 02/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X936451CAN Dental ProvidersDentist 
1223E0200X936451CAN Dental ProvidersDentistEndodontics
1223G0001X936451CAY Dental ProvidersDentistGeneral Practice
1223P0106X936451CAN Dental ProvidersDentistOral and Maxillofacial Pathology
1223P0221X936451CAN Dental ProvidersDentistPediatric Dentistry
1223P0300X936451CAN Dental ProvidersDentistPeriodontics
1223P0700X936451CAN Dental ProvidersDentistProsthodontics
1223S0112X936451CAN Dental ProvidersDentistOral and Maxillofacial Surgery
1223X0008X936451CAN Dental ProvidersDentistOral and Maxillofacial Radiology
1223X0400X936451CAN Dental ProvidersDentistOrthodontics and Dentofacial Orthopedics
122400000X936451CAN Dental ProvidersDenturist 

No ID Information.


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