Provider Demographics
NPI:1467544536
Name:YU, ERIC C (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
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:PO BOX 33701
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92163-3701
Mailing Address - Country:US
Mailing Address - Phone:619-298-9938
Mailing Address - Fax:
Practice Address - Street 1:550 WASHINGTON ST STE 727
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2232
Practice Address - Country:US
Practice Address - Phone:619-298-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38319207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G383190Medicaid
CAG38319Medicare ID - Type Unspecified
CA00G383190Medicaid