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General NPI Number Information
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NPI Number | 1164887196
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Entity Type | Organization
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Legal Business Name | EDDIE YUTI LO, MD, PC
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2171 JUNIPERO SERRA BLVD STE 388
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City | DALY CITY
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State | CA
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Zip | 94014-1985
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Country | US
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Telephone | 650-993-8349
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Fax | 650-993-8352
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Provider Business Mailing Address
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Address Line | 2171 JUNIPERO SERRA BLVD STE 388
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City | DALY CITY
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State | CA
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Zip | 94014-1985
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Country | US
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Telephone | 650-993-8349
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Fax | 650-993-8352
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Authorized Official
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Title or Position | MD
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Name | DR. EDDIE YUTI LO
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Credential | MD
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Telephone | 650-993-8349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A102816
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License Number State | CA
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