Provider Demographics
NPI:1548203110
Name:YU, LINDA C (PA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:YU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2190 LYNN ROAD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:805-557-7050
Mailing Address - Fax:805-557-4992
Practice Address - Street 1:2190 LYNN ROAD
Practice Address - Street 2:SUITE 290
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-557-7050
Practice Address - Fax:805-557-4992
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17500363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ34596Medicare UPIN
CAWPA17500BMedicare ID - Type Unspecified