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	207VG0400X	Gynecology Physician	14205551-1235	UT
2	207V00000X	Obstetrics & Gynecology Physician	MD465915	PA
3	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	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

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	:	05/13/2026

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

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