MEDICARE: TAECHIN YU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD465915	PA
2	207V00000X	Obstetrics & Gynecology Physician	22549	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22549	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1104865294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAECHIN YU M.D.

Provider Business Mailing Address
First Line	:	6355 S BUFFALO DR FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2133
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	2880 N TENAYA WAY STE 340
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0642
Country	:	US
Telephone Number	:	702-255-3547
Fax Number	:	702-307-2204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	09/13/2022

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Directions to “ TAECHIN YU M.D.” Practice Location

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