Healthcare Provider Details

I. General information

NPI: 1053270835
Provider Name (Legal Business Name): JONG E YU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CHULA VIS
IRVINE CA
92602-0951
US

IV. Provider business mailing address

73 CHULA VIS
IRVINE CA
92602-0951
US

V. Phone/Fax

Practice location:
  • Phone: 714-788-1952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC15068
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: