Provider Demographics
NPI:1689037376
Name:YAU, STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:YAU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:429 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4320
Mailing Address - Country:US
Mailing Address - Phone:196-434-0204
Mailing Address - Fax:619-337-0191
Practice Address - Street 1:429 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4320
Practice Address - Country:US
Practice Address - Phone:619-434-0204
Practice Address - Fax:619-337-0191
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA151069207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASY3232267556Medicaid