Healthcare Provider Details

I. General information

NPI: 1194441139
Provider Name (Legal Business Name): JEEHAH YU ND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CORPORATE PLAZA DR STE 100
NEWPORT BEACH CA
92660-7924
US

IV. Provider business mailing address

14482 SILVERBROOK DR
TUSTIN CA
92780-6322
US

V. Phone/Fax

Practice location:
  • Phone: 949-873-0146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: