Healthcare Provider Details

I. General information

NPI: 1689767584
Provider Name (Legal Business Name): DAVID K. YOO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 OAKVIEW DR
OAKLAND CA
94602-1946
US

IV. Provider business mailing address

1950 OAKVIEW DR
OAKLAND CA
94602-1946
US

V. Phone/Fax

Practice location:
  • Phone: 510-336-1956
  • Fax: 510-336-1956
Mailing address:
  • Phone: 510-336-1956
  • Fax: 510-336-1956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA83103
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA83103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: