Provider Demographics
NPI:1336472620
Name:Y BUSI INC
Entity Type:Organization
Organization Name:Y BUSI INC
Other - Org Name:YURI BUSI MD, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-244-0029
Mailing Address - Street 1:1030 S GLENDALE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2866
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1030 S GLENDALE AVE STE 302
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2866
Practice Address - Country:US
Practice Address - Phone:818-244-0029
Practice Address - Fax:818-244-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40872261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty