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NPI Code Detail

MEDICARE: JISANG YU MD

MEDICARE: JISANG YU MD
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
2207R00000XInternal Medicine Physician29598NV

General Provider Information

NPI Number : 1902591449
Entity Type Code : Individual
Provider Name (Legal Business Name) : JISANG YU MD
Provider Business Mailing Address
First Line : 1550 W CRAIG RD STE 220
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0329
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1550 W CRAIG RD STE 220
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0329
Country : US
Telephone Number : 702-616-5801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2023
Last Update Date : 06/25/2026

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Directions to “ JISANG YU MD” Practice Location

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