Basic Information
| Provider Information | |||||||||
| NPI: | 1053773481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YIP | ||||||||
| FirstName: | WESLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 N GARFIELD AVE | ||||||||
| Address2: | 308 | ||||||||
| City: | MONTEREY PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917541166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263756004 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 N STATE ST | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900331029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238653700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2016 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | A152770 | CA | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.