Healthcare Provider Details

I. General information

NPI: 1356229801
Provider Name (Legal Business Name): YI LUO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHY LUO

II. Dates (important events)

Enumeration Date: 08/23/2025
Last Update Date: 07/22/2026
Certification Date: 09/09/2025
Deactivation Date: 09/09/2025
Reactivation Date: 07/22/2026

III. Provider practice location address

9741 PONTOON WAY
NEWARK CA
94560-7354
US

IV. Provider business mailing address

9741 PONTOON WAY
NEWARK CA
94560-7354
US

V. Phone/Fax

Practice location:
  • Phone: 510-598-9528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: