Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A92691 | CA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | A92691 | CA |
NPI | 1073705778 |
---|---|
Provider Name | Son Ha Yu |
First Address | Rancho Mirage, CA 92270-5516 |
Second Address | Rancho Mirage, CA 92270-5516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 03/03/2020 |