Provider Demographics
NPI:1437506003
Name:YOO, ANDREW ELIOT (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ELIOT
Last Name:YOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5565 GROSSMONT BLVD
Mailing Address - Street 2:BUILDING 3, SUITE 256
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1526
Mailing Address - Country:US
Mailing Address - Phone:619-462-3131
Mailing Address - Fax:619-462-1731
Practice Address - Street 1:5565 GROSSMONT BLVD
Practice Address - Street 2:BUILDING 3, SUITE 256
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-462-3131
Practice Address - Fax:619-462-1731
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA00150484207X00000X, 207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program