Provider Demographics
NPI:1851302194
Name:YU, MICHELLE LYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LYN
Last Name:YU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N GARFIELD AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1700
Mailing Address - Country:US
Mailing Address - Phone:626-307-9000
Mailing Address - Fax:626-307-8968
Practice Address - Street 1:223 N GARFIELD AVE
Practice Address - Street 2:STE 205
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1700
Practice Address - Country:US
Practice Address - Phone:626-307-9000
Practice Address - Fax:626-307-8968
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61478207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A614780Medicaid
CAH01881Medicare UPIN