Healthcare Provider Details

I. General information

NPI: 1659436806
Provider Name (Legal Business Name): YAOHUI LI, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 MEDICAL CENTER CT
CHULA VISTA CA
91911-6617
US

IV. Provider business mailing address

PO BOX 568
MUNCIE IN
47308-0568
US

V. Phone/Fax

Practice location:
  • Phone: 765-284-0493
  • Fax: 765-284-2434
Mailing address:
  • Phone: 765-284-0493
  • Fax: 765-284-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA87413
License Number StateCA

VIII. Authorized Official

Name: YAOHUI LI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-795-6596