Provider Demographics
NPI:1013147198
Name:YU, CONNIE ANNE (DO)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:ANNE
Last Name:YU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E 28TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2743
Mailing Address - Country:US
Mailing Address - Phone:562-426-2662
Mailing Address - Fax:562-426-2665
Practice Address - Street 1:701 E 28TH ST STE 401
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2743
Practice Address - Country:US
Practice Address - Phone:562-426-2662
Practice Address - Fax:562-426-2665
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A11478207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine