Provider Demographics
NPI:1891864385
Name:YU, VICTORIA (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211925
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-1925
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 E DIMOND BLVD
Practice Address - Street 2:#14
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1908
Practice Address - Country:US
Practice Address - Phone:907-646-9990
Practice Address - Fax:907-646-9935
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK198152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKOD0198Medicaid
AKK152485Medicare PIN