MEDICARE: SUSAN SHU MEI YU RN

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	163WC0400X	Case Management Registered Nurse	547568	CA

General Provider Information

NPI Number	:	1861671976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN SHU MEI YU RN

Provider Business Mailing Address
First Line	:	30 VAN NESS AVE. SUITE 210
Second Line	:	MCAH, 30
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-2116
Country	:	US
Telephone Number	:	415-575-5732
Fax Number	:	415-575-5799

Provider Business Practice Location Address
First Line	:	30 VAN NESS AVE
Second Line	:	SUITE 210
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-6020
Country	:	US
Telephone Number	:	415-292-1339
Fax Number	:	415-440-6423

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

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	06/15/2010

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