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General NPI Number Information
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NPI Number | 1467438002
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Entity Type | Individual
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Provider Name | MI HWA YOO M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 2815 S MAIN ST SUITE 200
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City | CORONA
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State | CA
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Zip | 92882-2531
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Country | US
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Telephone | 951-255-1796
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Fax |
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Provider Business Mailing Address
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Address Line | 13080 SOLOMON PEAK DR
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City | RIVERSIDE
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State | CA
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Zip | 92503-8404
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Country | US
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Telephone | 951-255-1796
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G78754
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License Number State | CA
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