Provider Demographics
NPI:1306899208
Name:HWONG, YU (MD)
Entity type:Individual
Prefix:DR
First Name:YU
Middle Name:
Last Name:HWONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LAWRENCE
Other - Middle Name:Y
Other - Last Name:HWONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:STE 425
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1596
Mailing Address - Country:US
Mailing Address - Phone:408-998-1877
Mailing Address - Fax:408-998-1887
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:STE 425
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1596
Practice Address - Country:US
Practice Address - Phone:408-998-1877
Practice Address - Fax:408-998-1887
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG047398174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD33328Medicare UPIN
CA00G473980Medicare ID - Type Unspecified