Provider Demographics
NPI:1194171363
Name:YU, HAIMING (ABOC)
Entity type:Individual
Prefix:
First Name:HAIMING
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-4263
Mailing Address - Country:US
Mailing Address - Phone:626-817-9961
Mailing Address - Fax:626-551-4205
Practice Address - Street 1:2375 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4263
Practice Address - Country:US
Practice Address - Phone:626-817-9961
Practice Address - Fax:626-551-4205
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL40534156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician