Provider Demographics
NPI:1568515096
Name:YU, YANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:YANNA
Middle Name:
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 1:11729 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2819
Mailing Address - Country:US
Mailing Address - Phone:562-929-3923
Mailing Address - Fax:562-406-7589
Practice Address - Street 1:11729 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2819
Practice Address - Country:US
Practice Address - Phone:562-929-3923
Practice Address - Fax:562-406-7589
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12730T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist