Provider Demographics
NPI:1306011242
Name:YU, YUE (MD/PHD)
Entity Type:Individual
Prefix:
First Name:YUE
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26522 LA ALAMEDA
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6330
Mailing Address - Country:US
Mailing Address - Phone:949-282-1671
Mailing Address - Fax:949-367-0518
Practice Address - Street 1:26800 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6384
Practice Address - Country:US
Practice Address - Phone:949-542-8007
Practice Address - Fax:949-364-3430
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237721207N00000X
CAA111852207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A1118520Medicaid
CADZ301YMedicare PIN
CADZ301WMedicare PIN