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General NPI Number Information
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NPI Number | 1568802502
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Entity Type | Individual
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Provider Name | SAMUEL WAYNE YU M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 101 THE CITY DR S
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City | ORANGE
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State | CA
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Zip | 92868-3201
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Country | US
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Telephone | 847-990-0353
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 TORRANCE BLVD
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City | TORRANCE
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State | CA
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Zip | 90501-2835
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Country | US
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Telephone | 847-990-0353
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A127820
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License Number State | CA
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