Provider Demographics
NPI:1487744009
Name:ROSENKOETTER, YUKI K (PA)
Entity type:Individual
Prefix:
First Name:YUKI
Middle Name:K
Last Name:ROSENKOETTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10666 N TORREY PINES RD # N203
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1027
Mailing Address - Country:US
Mailing Address - Phone:858-554-8880
Mailing Address - Fax:858-554-8065
Practice Address - Street 1:10666 N TORREY PINES RD # N203
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1027
Practice Address - Country:US
Practice Address - Phone:858-554-8880
Practice Address - Fax:858-554-8065
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51509363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant