Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A35632 | CA |
NPI | 1043300809 |
---|---|
Provider Name | Mr. King-Yee Yu |
First Address | Pomona, CA 91767-3053 |
Second Address | Pomona, CA 91767-3053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 21/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A356320 | (05) | CA |
A27857 | (02) |