Healthcare Provider Details

I. General information

NPI: 1851917959
Provider Name (Legal Business Name): ANN YUFA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 W MARCH LN
STOCKTON CA
95207-6401
US

IV. Provider business mailing address

1611 W MARCH LN
STOCKTON CA
95207-6401
US

V. Phone/Fax

Practice location:
  • Phone: 209-226-4300
  • Fax: 209-227-1477
Mailing address:
  • Phone: 209-226-4300
  • Fax: 209-227-1477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMT221086
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: