Individual provider Active NPI

Gillian S Yeo, MD

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1588690077
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A112755 Issued in CA
Practice address
6973 Linda Vista Rd
San Diego, CA 92111-6342
Phone
(858) 279-0925
NPI assigned
Jun 25, 2006
Last updated
Feb 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A112755 CA Primary

Addresses

Primary practice location

6973 Linda Vista Rd
San Diego, CA 92111-6342

Mailing address

4865 Carriage Run Dr
San Diego, CA 92130-6952
Phone (310) 491-8991

Other identifiers 1

IdentifierTypeStateIssuer
408163300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104001051 CA Practitioner - Pediatric Medicine 5698873685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
112755CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Oct 22, 2012 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Pediatrics CurrentSince Oct 22, 2012 Accepting new patients

Locations

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1588690077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4865 CARRIAGE RUN DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306952",
            "telephone_number": "310-491-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6973 LINDA VISTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116342",
            "telephone_number": "858-279-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEO",
        "first_name": "GILLIAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A112755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408163300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.