1346459179 NPI number — DR. ELIZABETH CHOE YU MD

Table of content: DR. ELIZABETH CHOE YU MD (NPI 1346459179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346459179 NPI number — DR. ELIZABETH CHOE YU MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YU
Provider First Name:
ELIZABETH
Provider Middle Name:
CHOE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHOE
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
YOONJUNG
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346459179
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1321 RIMROCK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95120-5610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-799-5621
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
751 S BASCOM AVE
Provider Second Line Business Practice Location Address:
STE 340
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95128-2604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-885-2340
Provider Business Practice Location Address Fax Number:
408-793-2596
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A98625 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: A98625 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A98625 . This is a "THE MEDICAL BOARD OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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