Provider Demographics
NPI:1750440764
Name:OU, YOLANDE (MD)
Entity type:Individual
Prefix:
First Name:YOLANDE
Middle Name:
Last Name:OU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3342 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-2206
Mailing Address - Country:US
Mailing Address - Phone:323-267-1214
Mailing Address - Fax:323-267-0282
Practice Address - Street 1:3342 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2206
Practice Address - Country:US
Practice Address - Phone:323-267-1214
Practice Address - Fax:323-267-0282
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA051772208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A517720Medicaid
CAA51772Medicare ID - Type Unspecified
CA00A517720Medicaid