MEDICARE: DR. ROGINELLI OCAMPO 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	207Q00000X	Family Medicine Physician	A54855	CA

General Provider Information

NPI Number	:	1730218751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGINELLI OCAMPO YU M.D.

Provider Business Mailing Address
First Line	:	3460 KATELLA AVE
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2334
Country	:	US
Telephone Number	:	562-594-6599
Fax Number	:	592-795-0029

Provider Business Practice Location Address
First Line	:	10601 WALKER ST
Second Line	:	SUITE 250
City	:	CYPRESS
State	:	CA
Zip	:	90630-4733
Country	:	US
Telephone Number	:	714-252-8311
Fax Number	:	714-252-8339

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	03/27/2014

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