Basic Information
| Provider Information | |||||||||
| NPI: | 1114941598 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YEDLIN | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6056 OCEAN VIEW DR | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946181845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105473521 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3100 TELEGRAPH AVE | ||||||||
| Address2: | 2ND FLOOR BAYSIDE MEDICAL GROUP | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104525231 | ||||||||
| FaxNumber: | 5108898392 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 03/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0120X | G60214 | CA | Y | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery |
No ID Information.