Individual provider Active NPI

Leisure Yu, MD, PHD

  • Specialist
  • Loma Linda, CA
National Provider Identifier
1811960875
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G62381 Issued in CA
Practice address
10459 Mt View Ave
Suite D
Loma Linda, CA 92354-2033
Phone
(909) 799-3838
Fax
(909) 799-3830
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G62381 CA Primary

Addresses

Primary practice location

10459 Mt View Ave
Suite D
Loma Linda, CA 92354-2033

Mailing address

30688 Country Club Dr
Redlands, CA 92373-7619
Phone (909) 214-2105

Other identifiers 4

IdentifierTypeStateIssuer
00G623810MedicaidCA
P00143603OtherCAMEDICARE RAILROAD
1578756979OtherCANPI TYPE II
602135600OtherCAUS DEPT. LABOR NUMBER

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 Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
62381CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1811960875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30688 COUNTRY CLUB DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737619",
            "telephone_number": "909-214-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10459 MT VIEW AVE",
            "address_2": "SUITE D",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542033",
            "telephone_number": "909-799-3838",
            "fax_number": "909-799-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "LEISURE",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G62381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G623810",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00143603",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE II",
            "identifier": "1578756979",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT. LABOR NUMBER",
            "identifier": "602135600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.