Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 110486 | MO |
NPI | 1003959248 |
---|---|
Provider Name | Dr. Cecilia H Yu |
First Address | O Fallon, MO 63368-2206 |
Second Address | O Fallon, MO 63368-2206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200026275 | (05) | MO |