Provider Demographics
NPI:1467706325
Name:YU, QI TONG (DO)
Entity Type:Individual
Prefix:DR
First Name:QI
Middle Name:TONG
Last Name:YU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25455 BARTON RD
Mailing Address - Street 2:SUITE 206A
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3128
Mailing Address - Country:US
Mailing Address - Phone:909-558-6526
Mailing Address - Fax:909-558-6701
Practice Address - Street 1:25455 BARTON RD
Practice Address - Street 2:SUITE 206A
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3128
Practice Address - Country:US
Practice Address - Phone:909-558-6526
Practice Address - Fax:909-558-6701
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14751207R00000X
AZ006854207R00000X
AZNONE207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine