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General NPI Number Information
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NPI Number | 1003277260
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Entity Type | Individual
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Provider Name | SOOJIN YU NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 1781 3RD ST
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City | NORCO
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State | CA
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Zip | 92860
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Country | US
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Telephone | 951-279-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 996 EVENING CANYON RD
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City | BREA
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State | CA
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Zip | 92821-2612
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Country | US
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Telephone | 714-833-7556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95003819
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License Number State | CA
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