Provider Demographics
NPI:1821130238
Name:YOO, STEVEN S (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:YOO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9042 GARDEN GROVE BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1370
Mailing Address - Country:US
Mailing Address - Phone:714-530-6611
Mailing Address - Fax:714-415-5512
Practice Address - Street 1:9042 GARDEN GROVE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1370
Practice Address - Country:US
Practice Address - Phone:714-530-6611
Practice Address - Fax:714-415-5512
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10099T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0100990Medicaid
CAOP10099Medicare PIN
CAU44132Medicare UPIN