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General NPI Number Information
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NPI Number | 1174830624
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Entity Type | Individual
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Provider Name | DR. YONG QU
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Gender | Female
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Dates
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Enumeration Date | 09/04/2010
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Last Update Date | 01/20/2014
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Provider Practice Location Address
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Address Line | 5 MASON STE 100
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City | IRVINE
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State | CA
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Zip | 92618-2550
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Country | US
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Telephone | 949-812-6902
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Fax |
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Provider Business Mailing Address
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Address Line | 5 MASON STE 100
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City | IRVINE
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State | CA
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Zip | 92618-2550
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Country | US
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Telephone | 949-812-6902
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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 | 246ZG1000X
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Taxonomy Name | Medical Geneticist (PhD) Specialist/Technologist
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License Number | DRN12
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 246ZG1000X
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Taxonomy Name | Medical Geneticist (PhD) Specialist/Technologist
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License Number | QUXXY1
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License Number State | NY
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