Provider Demographics
NPI:1497869630
Name:YU, FANG FRANK
Entity Type:Individual
Prefix:
First Name:FANG
Middle Name:FRANK
Last Name:YU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:15825 LAGUNA CANYON RD.,
Mailing Address - Street 2:106
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-679-0000
Mailing Address - Fax:949-679-0976
Practice Address - Street 1:15825 LAGUNA CANYON RD.,
Practice Address - Street 2:106
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:949-679-0000
Practice Address - Fax:949-679-0976
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66256207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A662560Medicaid
CAA66256Medicare ID - Type Unspecified
CA00A662560Medicaid