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General NPI Number Information
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NPI Number | 1295803104
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Entity Type | Individual
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Provider Name | MARY ANNE MAIPID YU DDM
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 06/29/2008
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Provider Practice Location Address
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Address Line | 1253 W EL CAMINO REAL #B
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City | SUNNYVALE
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State | CA
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Zip | 94087-1062
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Country | US
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Telephone | 650-938-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3061 MARICOTTE DR
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City | PALMDALE
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State | CA
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Zip | 93550-2438
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Country | US
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Telephone | 661-267-2475
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52641
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License Number State | CA
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