Healthcare Provider Details

I. General information

NPI: 1114584158
Provider Name (Legal Business Name): SAI FAN YU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 SHAW AVE STE 125
CLOVIS CA
93612-3865
US

IV. Provider business mailing address

334 SHAW AVE STE 125
CLOVIS CA
93612-3865
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-8000
  • Fax: 559-297-3480
Mailing address:
  • Phone: 559-297-8000
  • Fax: 559-297-3480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. SAI FAN YU
Title or Position: DENTIST
Credential:
Phone: 415-608-0021