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General NPI Number Information
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NPI Number | 1255361960
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Entity Type | Organization
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Legal Business Name | CHIEN S. YU, M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 320 SUPERIOR AVE SUITE@220
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2716
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Country | US
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Telephone | 949-548-7777
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Fax | 949-548-8588
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Provider Business Mailing Address
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Address Line | 320 SUPERIOR AVE SUITE@220
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2716
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Country | US
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Telephone | 949-548-7777
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Fax | 949-548-8588
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MICHAEL SAN YU
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Credential | M.D.
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Telephone | 949-548-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A72458
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License Number State | CA
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