1790065621 NPI number — YING CHI MD INC.

Table of content: (NPI 1790065621)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790065621 NPI number — YING CHI MD INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YING CHI MD INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790065621
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11190 WARNER AVE
Provider Second Line Business Mailing Address:
SUITE 307
Provider Business Mailing Address City Name:
FOUNTAIN VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92708-4019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-443-4351
Provider Business Mailing Address Fax Number:
714-434-3759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11190 WARNER AVE
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
FOUNTAIN VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92708-4019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-434-3518
Provider Business Practice Location Address Fax Number:
714-434-3759
Provider Enumeration Date:
08/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CHI
Authorized Official First Name:
YING
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-434-3518

Provider Taxonomy Codes

  • Taxonomy code: 207XS0106X , with the licence number:  A107272 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4302721 . This is a "MEDICARE PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1518178169 . This is a "NPI 1" identifier . This identifiers is of the category "OTHER".




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