Provider Demographics
NPI:1407918055
Name:YU, CINDY SOYOUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:SOYOUNG
Last Name:YU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20355 STEVENS CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2225
Mailing Address - Country:US
Mailing Address - Phone:408-777-8771
Mailing Address - Fax:408-777-8750
Practice Address - Street 1:20355 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2225
Practice Address - Country:US
Practice Address - Phone:408-777-8771
Practice Address - Fax:408-777-8750
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8907T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-3174163OtherEIN