Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 200 | NM |
Y | 222Z00000X | Podiatrist | 200 | NM |
NPI | 1053304261 |
---|---|
Provider Name | Hsiao-Chun Yu |
First Address | Las Cruces, NM 88001-1425 |
Second Address | Las Cruces, NM 88001-1425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 29/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0469220001 | DMERC (01) | NM |
28155 | PRESBYTERIAN (01) | NM |
63033 | (05) | NM |
88001A003 | TRICARE (WPS) (01) | NM |
NM005365 | BC/BS (01) | NM |
T41108 | (02) |