Healthcare Provider Details

I. General information

NPI: 1720945504
Provider Name (Legal Business Name): YAN YU LOK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3269 D ST
FAIRVIEW CA
94541-4585
US

IV. Provider business mailing address

803 DECOTO RD
UNION CITY CA
94587-3514
US

V. Phone/Fax

Practice location:
  • Phone: 510-537-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: