Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 59531 | CA |
NPI | 1013215987 |
---|---|
Provider Name | Dr. David Chun-Te Yu |
First Address | San Diego, CA 92110-5343 |
Second Address | San Diego, CA 92110-5343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2011 |
Last Update Date | 02/03/2011 |