Provider Demographics
NPI:1225104193
Name:YU, WENGUI (MD)
Entity Type:Individual
Prefix:
First Name:WENGUI
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S MANCHESTER AVE # 206E
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3217
Mailing Address - Country:US
Mailing Address - Phone:714-456-7002
Mailing Address - Fax:714-456-3652
Practice Address - Street 1:200 S MANCHESTER AVE # 206E
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3217
Practice Address - Country:US
Practice Address - Phone:714-456-7002
Practice Address - Fax:714-456-3652
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA794312084N0400X, 2084A2900X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H62589Medicare UPIN