Basic Information
| Provider Information | |||||||||
| NPI: | 1417077967 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YU YAO MD A PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 E VALLEY BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SAN GABRIEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917766510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262881918 | ||||||||
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| Practice Location | |||||||||
| Address1: | 230 E VALLEY BLVD, | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SAN GABRIEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917766507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262881918 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 02/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | YAO | ||||||||
| AuthorizedOfficialFirstName: | WINNIE | ||||||||
| AuthorizedOfficialMiddleName: | XU | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6262881918 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00A553700 | 05 | CA | MEDICAID |