Provider Demographics
NPI:1154856730
Name:YU, VICTORIA YUIWEN
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:YUIWEN
Last Name:YU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 KEYSTONE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-4699
Mailing Address - Country:US
Mailing Address - Phone:973-876-0462
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL PLAZA DRIVEWAY
Practice Address - Street 2:SUITE B265
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program