Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ML20007653 | WA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A108402 | CA |
NPI | 1578674859 |
---|---|
Provider Name | Sirius K. Yoo |
First Address | San Diego, CA 92127-3445 |
Second Address | Stanford, CA 94305-5739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 06/03/2014 |