Basic Information
| Provider Information | |||||||||
| NPI: | 1740290329 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREEN-YEH | ||||||||
| FirstName: | ROBBIN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1411 EAST 31ST STREET | ||||||||
| Address2: | OAKCARE MEDICAL GROUP | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103461468 | ||||||||
| FaxNumber: | 5108957286 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 S SHORE CTR W STE 103F | ||||||||
| Address2: | |||||||||
| City: | ALAMEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945015762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108144630 | ||||||||
| FaxNumber: | 5108144644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2006 | ||||||||
| LastUpdateDate: | 10/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 20A6757 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00AX67570 | 05 | CA | MEDICAID |