1952374100 NPI number — DR. CHIFOO DAVID YUE MD

Table of content: DR. CHIFOO DAVID YUE MD (NPI 1952374100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952374100 NPI number — DR. CHIFOO DAVID YUE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YUE
Provider First Name:
CHIFOO
Provider Middle Name:
DAVID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YUE
Provider Other First Name:
C. DAVID
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952374100
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5309 LINCOLN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CYPRESS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90630-2235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-484-8111
Provider Business Mailing Address Fax Number:
562-866-8115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5309 LINCOLN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90630-2235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-484-8111
Provider Business Practice Location Address Fax Number:
714-699-1410
Provider Enumeration Date:
02/08/2006

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: 208000000X , with the licence number:  G68013 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: G68013 , 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: WG68013G . This is a "MEDICARE PPIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00G680130 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470902916 . This is a "TRICARE NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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