Healthcare Provider Details

I. General information

NPI: 1073475745
Provider Name (Legal Business Name): BO YU DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1391 S DIAMOND BAR BLVD
DIAMOND BAR CA
91765-2208
US

IV. Provider business mailing address

1391 S DIAMOND BAR BLVD
DIAMOND BAR CA
91765-2208
US

V. Phone/Fax

Practice location:
  • Phone: 909-903-8885
  • Fax:
Mailing address:
  • Phone: 909-903-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BO YU
Title or Position: OWNER
Credential: DDS, PHD, FACD
Phone: 424-393-6558