MEDICARE: DR. YI YI STEPHANIE GU M.D.

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	207RR0500X	Rheumatology Physician	A88414	CA

General Provider Information

NPI Number	:	1932183472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YI YI STEPHANIE GU M.D.

Provider Business Mailing Address
First Line	:	350 30TH ST
Second Line	:	#320
City	:	OAKLAND
State	:	CA
Zip	:	94609-3424
Country	:	US
Telephone Number	:	510-465-6700
Fax Number	:	510-465-7765

Provider Business Practice Location Address
First Line	:	350 30TH ST
Second Line	:	#320
City	:	OAKLAND
State	:	CA
Zip	:	94609-3424
Country	:	US
Telephone Number	:	510-465-6700
Fax Number	:	510-465-7765

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

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	01/06/2022

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