Provider Demographics
NPI:1578776639
Name:YU, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 N SAN MATEO DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2777
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 N SAN MATEO DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2777
Practice Address - Country:US
Practice Address - Phone:650-344-1114
Practice Address - Fax:650-344-2274
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99819207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN