Healthcare Provider Details

I. General information

NPI: 1942510938
Provider Name (Legal Business Name): MR. SAM YAU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9353 VALLEY BLVD
ROSEMEAD CA
91770-1934
US

IV. Provider business mailing address

PO BOX 4505
MONTEBELLO CA
90640-9309
US

V. Phone/Fax

Practice location:
  • Phone: 626-287-2988
  • Fax:
Mailing address:
  • Phone: 323-496-0312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: