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General NPI Number Information
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NPI Number | 1205127552
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Entity Type | Individual
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Provider Name | EUN YU
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Gender | Male
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 05/05/2017
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Provider Practice Location Address
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Address Line | 130 W VICTORIA ST
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City | GARDENA
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State | CA
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Zip | 90248-3523
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Country | US
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Telephone | 310-715-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 6300 BATAAN ST.
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City | CYPRESS
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State | CA
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Zip | 90630
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Country | US
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Telephone | 213-407-2175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 13777
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License Number State | CA
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