Individual
YEEYIE EVA FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
(510) 732-1357
Mailing address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
(510) 732-1357
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A78233
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A782330
—
CA
01
—
EL487Z
MEDICARE PTAN
—
Enumeration date
11/17/2006
Last updated
01/18/2022
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