Individual provider Active NPI

Simon Gin Hao Yu, DC

  • Chiropractor
  • San Bruno, CA
National Provider Identifier
1962575506
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27001 Issued in CA
Practice address
654 Jenevein Ave
San Bruno, CA 94066
Phone
(650) 877-0999
Fax
(650) 877-0960
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27001 CA Primary

Addresses

Primary practice location

654 Jenevein Ave
San Bruno, CA 94066

Mailing address

654 Jenevein Ave
San Bruno, CA 94066
Phone (650) 877-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040526000702 CA Practitioner - Chiropractic 4688655608 Reassigns benefits to 1 organization
Practice locations: San Bruno, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Worldwide Integrative Healthcare IncGroup PAC ID 6507009230, 2 clinicians

Practice addresses (Care Compare)

654 Jenevein Ave
San Bruno, CA 94066-4230
Phone (650) 877-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC27001CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Worldwide Integrative Healthcare, Inc. Chiropractor CurrentSince May 1, 2015 Accepting new patients

Locations

654 Jenevein Ave
San Bruno, CA 94066
Phone (650) 877-0999

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1962575506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 JENEVEIN AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "94066",
            "telephone_number": "650-877-0999",
            "fax_number": "650-877-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 JENEVEIN AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "94066",
            "telephone_number": "650-877-0999",
            "fax_number": "650-877-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "SIMON",
        "middle_name": "GIN HAO",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.