Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | NP95003819 | CA |
NPI | 1003277260 |
---|---|
Provider Name | Soojin Yu |
First Address | Brea, CA 92821-2612 |
Second Address | Norco, CA 92860 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2016 |
Last Update Date | 20/07/2018 |