Provider Demographics
NPI:1851599872
Name:WONG, YOLANDA YU-CHIU (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:YU-CHIU
Last Name:WONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:YU-CHIU
Other - Last Name:KUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4305 UNIVERSITY AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1690
Mailing Address - Country:US
Mailing Address - Phone:619-280-2058
Mailing Address - Fax:
Practice Address - Street 1:4305 UNIVERSITY AVE STE 150
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105
Practice Address - Country:US
Practice Address - Phone:619-280-2058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94449208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics