Basic Information
Provider Information
NPI: 1538229430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RU
FirstName: YIN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21003 TRIGGER LN
Address2:  
City: DIAMOND BAR
State: CA
PostalCode: 917653472
CountryCode: US
TelephoneNumber: 9095950099
FaxNumber:  
Practice Location
Address1: VALLEY OBSTETRICS & GYNECOLOGY MEDICAL GROUP
Address2: 400 N. PEPPER AVE 6TH FLOOR. SOUTH
City: COLTON
State: CA
PostalCode: 92324
CountryCode: US
TelephoneNumber: 9095806333
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
176B00000X1679CAY Other Service ProvidersMidwife 

No ID Information.


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