Provider Demographics
NPI:1588873533
Name:YU, CHRISTINE H (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:H
Last Name:YU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 SILVERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-8964
Mailing Address - Country:US
Mailing Address - Phone:703-475-4908
Mailing Address - Fax:
Practice Address - Street 1:1115 N IMPERIAL AVE
Practice Address - Street 2:ICE MEDICAL REFERRAL CENTER
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1739
Practice Address - Country:US
Practice Address - Phone:760-336-4710
Practice Address - Fax:760-353-8642
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist