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General NPI Number Information
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NPI Number | 1215435292
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Entity Type | Organization
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Legal Business Name | YUJIA YAO
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 1670 WESTWOOD DR STE K
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City | SAN JOSE
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State | CA
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Zip | 95125-5111
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Country | US
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Telephone | 408-826-4676
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 WESTWOOD DR STE K
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City | SAN JOSE
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State | CA
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Zip | 95125-5111
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Country | US
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Telephone | 408-826-4676
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YUJIA YAO
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Credential |
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Telephone | 626-324-4903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 100258
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License Number State | CA
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