MEDICARE: DR. LAWRENCE YU O.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	152W00000X	Optometrist	15274	CA

General Provider Information

NPI Number	:	1861873861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE YU O.D.

Provider Business Mailing Address
First Line	:	75 ENTERPRISE STE 200
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-2626
Country	:	US
Telephone Number	:	949-688-6205
Fax Number	:

Provider Business Practice Location Address
First Line	:	23550 HAWTHORNE BLVD STE 220
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-4722
Country	:	US
Telephone Number	:	562-222-3120
Fax Number	:	310-784-2021

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

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	08/16/2022

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