Provider Demographics
NPI:1457756108
Name:GEORGE C. YU, MD, INC.
Entity Type:Organization
Organization Name:GEORGE C. YU, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-389-5132
Mailing Address - Street 1:3661 LAS POSAS RD STE G162
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1430
Mailing Address - Country:US
Mailing Address - Phone:805-389-5132
Mailing Address - Fax:805-482-7697
Practice Address - Street 1:3661 LAS POSAS RD STE G162
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1430
Practice Address - Country:US
Practice Address - Phone:805-389-5132
Practice Address - Fax:805-482-7697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB222943Medicare PIN