Provider Demographics
NPI:1245231968
Name:YU, GEORGE C (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
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 1:3661 LAS POSAS RD STE G162
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1430
Mailing Address - Country:US
Mailing Address - Phone:805-389-5132
Mailing Address - Fax:805-482-7697
Practice Address - Street 1:3661 LAS POSAS RD STE G162
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1430
Practice Address - Country:US
Practice Address - Phone:805-389-5132
Practice Address - Fax:805-482-7697
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44905174400000X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE83321Medicare UPIN
CACB222963Medicare PIN
CACB222943Medicare PIN