Provider Demographics
NPI:1861474181
Name:YU, SANTOS H (MD)
Entity Type:Individual
Prefix:
First Name:SANTOS
Middle Name:H
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 W HORIZON RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2648
Mailing Address - Country:US
Mailing Address - Phone:702-247-9994
Mailing Address - Fax:702-651-9995
Practice Address - Street 1:2430 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2648
Practice Address - Country:US
Practice Address - Phone:702-247-9994
Practice Address - Fax:702-651-9995
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV113842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ93560Medicaid
NVI39661Medicare UPIN
NVV101224Medicare PIN
AZ93560Medicaid