Active NPI
Diana Yu, D.O.
- Pediatrics Physician
- Fontana, CA
National Provider Identifier
1790147510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A17263
- Practice address
- 16465 Sierra Lakes Pkwy Ste 275
Fontana, CA 92336 - Phone
- (909) 823-8000
- Fax
- (909) 823-8088
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A17263 | CA | Primary |
Addresses
Primary practice location
16465 Sierra Lakes Pkwy Ste 275
Fontana, CA 92336
Mailing address
16465 Sierra Lakes Pkwy Ste 275
Fontana, CA 92336-1263
Phone (909) 823-8000
Other practice location 1
811 E 11th St Ste 201
Upland, CA 91786-4872
Phone (909) 985-0883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A17263 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal MDS | Pediatrics | Past | Accepting new patients |
| Pediatric Subspecialty Faculty, Inc. | Pediatrics | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- dryu@goldenstatepediatrics.opdirect.net
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Pomona, CA
- NPI 1366447781
-
- Pediatrics Physician
- Orange, CA
- NPI 1790850279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1790147510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16465 SIERRA LAKES PKWY STE 275",
"city": "FONTANA",
"state": "CA",
"postal_code": "923361263",
"telephone_number": "909-823-8000",
"fax_number": "909-823-8088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16465 SIERRA LAKES PKWY STE 275",
"city": "FONTANA",
"state": "CA",
"postal_code": "92336",
"telephone_number": "909-823-8000",
"fax_number": "909-823-8088"
}
],
"practiceLocations": [
{
"address_1": "811 E 11th St Ste 201",
"address_purpose": "LOCATION",
"city": "Upland",
"state": "CA",
"postal_code": "917864872",
"country_code": "US",
"telephone_number": "909-985-0883",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YU",
"first_name": "DIANA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A17263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.