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General NPI Number Information
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NPI Number | 1528515996
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Entity Type | Organization
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Legal Business Name | YONGBING L PU MD PLLC
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 317 OFFICE SQUARE LN STE B102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462
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Country | US
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Telephone | 757-469-6003
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Fax |
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Provider Business Mailing Address
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Address Line | 317 OFFICE SQUARE LN STE B102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3650
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Country | US
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Telephone | 757-469-6003
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YONGBING L PU
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Credential | M.D.
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Telephone | 757-469-6003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101253996
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License Number State | VA
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