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NPI Code Detail

MEDICARE: AMANDA EVELYN YU DO, PHD

MEDICARE: AMANDA EVELYN YU DO, PHD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1255699948
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA EVELYN YU DO, PHD
Provider Business Mailing Address
First Line : 200 W ARBOR DR
Second Line : MC 8465
City : SAN DIEGO
State : CA
Zip : 92103-9000
Country : US
Telephone Number : 619-543-6222
Fax Number :
Provider Business Practice Location Address
First Line : 200 W ARBOR DR
Second Line : MC 8465
City : SAN DIEGO
State : CA
Zip : 92103-9000
Country : US
Telephone Number : 619-543-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2012
Last Update Date : 12/15/2021

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