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General NPI Number Information
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NPI Number | 1184636268
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Entity Type | Organization
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Legal Business Name | JAN YUO, M.D. INC.
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/13/2009
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Provider Practice Location Address
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Address Line | 2490 HONOLULU AVE STE 128
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City | MONTROSE
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State | CA
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Zip | 91020-1800
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Country | US
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Telephone | 818-330-9960
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Fax | 818-330-9963
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Provider Business Mailing Address
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Address Line | 2490 HONOLULU AVE STE 128
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City | MONTROSE
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State | CA
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Zip | 91020-1800
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Country | US
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Telephone | 818-330-9960
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Fax | 818-330-9963
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAN JENG YUO
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Credential | M.D.
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Telephone | 818-330-9960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | A37730
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A37730
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License Number State | CA
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