Provider Demographics
NPI:1194750612
Name:QIU, YUMIN (MD)
Entity type:Individual
Prefix:DR
First Name:YUMIN
Middle Name:
Last Name:QIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 S WESTLAKE BLVD UNIT F
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1919
Mailing Address - Country:US
Mailing Address - Phone:805-405-4377
Mailing Address - Fax:805-496-3841
Practice Address - Street 1:2438 N PONDEROSA DR
Practice Address - Street 2:BUILDING C, SUITTE 201
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-2369
Practice Address - Country:US
Practice Address - Phone:805-484-4612
Practice Address - Fax:805-496-3841
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75287207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH82924Medicare UPIN
CAA75287AMedicare ID - Type Unspecified