Provider Demographics
NPI:1104039874
Name:YUNG, YUET SAU (RN)
Entity Type:Individual
Prefix:MR
First Name:YUET
Middle Name:SAU
Last Name:YUNG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 MANDARIN CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4662
Mailing Address - Country:US
Mailing Address - Phone:209-571-2812
Mailing Address - Fax:
Practice Address - Street 1:1125 MANDARIN CT
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4662
Practice Address - Country:US
Practice Address - Phone:209-571-2812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA497821163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA497821OtherCALIFORNIA NURSING LICENC