Provider Demographics
NPI:1649269465
Name:KU, NORA CHIEN YEE (MD)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:CHIEN YEE
Last Name:KU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N PROSPECT AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3040
Mailing Address - Country:US
Mailing Address - Phone:310-750-3300
Mailing Address - Fax:310-750-3381
Practice Address - Street 1:514 N PROSPECT AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3040
Practice Address - Country:US
Practice Address - Phone:310-750-3300
Practice Address - Fax:310-750-3381
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46045207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A046045OtherBLUE SHIELD
F22774Medicare UPIN
WA46045BMedicare ID - Type Unspecified
00A046045OtherBLUE SHIELD