Provider Demographics
NPI:1104015429
Name:YU CARE MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:YU CARE MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-626-5143
Mailing Address - Street 1:210 N GARFIELD AVE
Mailing Address - Street 2:203
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1746
Mailing Address - Country:US
Mailing Address - Phone:626-307-7397
Mailing Address - Fax:626-307-1807
Practice Address - Street 1:711 W COLLEGE ST
Practice Address - Street 2:328
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1163
Practice Address - Country:US
Practice Address - Phone:213-626-5143
Practice Address - Fax:213-626-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35356208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0078251Medicaid
CAGR0078251Medicaid