Provider Demographics
NPI:1255587762
Name:YU, KATHY (MD)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:YU-SYKEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17742 BEACH BLVD STE 345
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6872
Mailing Address - Country:US
Mailing Address - Phone:714-375-4224
Mailing Address - Fax:714-375-4231
Practice Address - Street 1:17742 BEACH BLVD STE 345
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6872
Practice Address - Country:US
Practice Address - Phone:714-375-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109401207Y00000X, 207YP0228X
NY241610207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology