Healthcare Provider Details

I. General information

NPI: 1457756108
Provider Name (Legal Business Name): GEORGE C. YU, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 12/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 LAS POSAS RD STE G162
CAMARILLO CA
93010-1430
US

IV. Provider business mailing address

3661 LAS POSAS RD STE G162
CAMARILLO CA
93010-1430
US

V. Phone/Fax

Practice location:
  • Phone: 805-389-5132
  • Fax: 805-482-7697
Mailing address:
  • Phone: 805-389-5132
  • Fax: 805-482-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: GEORGE C YU
Title or Position: CEO
Credential: M.D.
Phone: 805-389-5132