Provider Demographics
NPI:1295776672
Name:YOO, CHRISTOPHER JAMES (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:YOO
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:P.O. BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3418
Mailing Address - Fax:
Practice Address - Street 1:1501 TROUSDALE DR
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4506
Practice Address - Country:US
Practice Address - Phone:650-696-5515
Practice Address - Fax:650-696-5280
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA876732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1295776672Medicaid
CAP00142625OtherRAILROAD MEDICARE
CA00A876730Medicaid
NV1295776672Medicaid
CA00A876735Medicare PIN
CA00A876736Medicare PIN
CA00A876739Medicare PIN
NVV104972Medicare PIN
CA00A876730Medicare PIN
CAP00142625OtherRAILROAD MEDICARE
CA00A876734Medicare PIN
CA00A8767311Medicare PIN
CA00A876732Medicare PIN
CA00A876738Medicare PIN
CA00A8767312Medicare PIN
CA00A8767310Medicare PIN
CA00A876730Medicaid
CA00A876737Medicare PIN