Healthcare Provider Details

I. General information

NPI: 1174679393
Provider Name (Legal Business Name): HON YU, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 S BRISTOL ST SUITE 208
SANTA ANA CA
92704-5766
US

IV. Provider business mailing address

2621 S BRISTOL ST SUITE 208
SANTA ANA CA
92704-5766
US

V. Phone/Fax

Practice location:
  • Phone: 714-210-2450
  • Fax: 714-210-2454
Mailing address:
  • Phone: 714-210-2450
  • Fax: 714-210-2454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA34779
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA34779
License Number StateCA

VIII. Authorized Official

Name: DR. HON YU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-210-2450