Provider Demographics
NPI:1194748806
Name:TU, YUMIN (DDS)
Entity type:Individual
Prefix:DR
First Name:YUMIN
Middle Name:
Last Name:TU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10737 CAMINO RUIZ
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2359
Mailing Address - Country:US
Mailing Address - Phone:858-693-3987
Mailing Address - Fax:858-566-8997
Practice Address - Street 1:10737 CAMINO RUIZ
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-2359
Practice Address - Country:US
Practice Address - Phone:858-693-3987
Practice Address - Fax:858-566-8997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93370-01Medicare ID - Type UnspecifiedMEDI-CAL NUMBER