Healthcare Provider Details

I. General information

NPI: 1477713444
Provider Name (Legal Business Name): CHIFOO DAVID YUE MD A PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5309 LINCOLN AVE
CYPRESS CA
90630-2235
US

IV. Provider business mailing address

5309 LINCOLN AVE
CYPRESS CA
90630-2235
US

V. Phone/Fax

Practice location:
  • Phone: 714-484-8111
  • Fax:
Mailing address:
  • Phone: 714-484-8111
  • Fax: 714-699-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG68013
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG68013
License Number StateCA

VIII. Authorized Official

Name: DR. CHIFOO DAVID YUE
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 714-484-8111