Provider Demographics
NPI:1164678850
Name:YOO, SARAH H (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:H
Last Name:YOO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:H
Other - Last Name:YI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23550 HAWTHORNE BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4722
Mailing Address - Country:US
Mailing Address - Phone:562-222-3120
Mailing Address - Fax:310-784-2021
Practice Address - Street 1:200 STEIN PLZ
Practice Address - Street 2:1-340
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13562152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT135620Medicaid
CAFG323ZMedicare PIN