Healthcare Provider Details

I. General information

NPI: 1013781970
Provider Name (Legal Business Name): YU ZUO DAOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39210 STATE ST STE 117
FREMONT CA
94538-1456
US

IV. Provider business mailing address

39210 STATE ST STE 117
FREMONT CA
94538-1456
US

V. Phone/Fax

Practice location:
  • Phone: 510-288-8710
  • Fax:
Mailing address:
  • Phone: 510-288-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number19908
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: