MEDICARE: REJUVENEXX, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	A90085	CA

General Provider Information

NPI Number	:	1043404908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REJUVENEXX, INC

Provider Business Mailing Address
First Line	:	9726 E LAS TUNAS DR
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-2242
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9726 E LAS TUNAS DR
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-2242
Country	:	US
Telephone Number	:	626-285-0508
Fax Number	:

Authorized Official
Title or Position	:	DIRECTO
Name	:	DR. ART YU
Credential	:	M.D.
Telephone Number	:	626-285-0508

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	09/04/2007

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Directions to “REJUVENEXX, INC ” Practice Location

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