MEDICARE: VICTORIA YUIWEN YU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1154856730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA YUIWEN YU

Provider Business Mailing Address
First Line	:	3321 KEYSTONE AVE APT 3
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-4699
Country	:	US
Telephone Number	:	973-876-0462
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MEDICAL PLAZA DRIVEWAY
Second Line	:	SUITE B265
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-0001
Country	:	US
Telephone Number	:	310-825-9775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	04/20/2017

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Directions to “ VICTORIA YUIWEN YU ” Practice Location

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