Provider Demographics
NPI:1912185059
Name:POON, YUKIKO KASHIWA (MD)
Entity Type:Individual
Prefix:
First Name:YUKIKO
Middle Name:KASHIWA
Last Name:POON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YUKIKO
Other - Middle Name:
Other - Last Name:KASHIWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST.
Mailing Address - Street 2:LLUMC, HOUSE STAFF OFFICE CP 21005
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON ST.
Practice Address - Street 2:LLUMC, HOUSE STAFF OFFICE CP 21005
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354
Practice Address - Country:US
Practice Address - Phone:909-558-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA105711208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program