MEDICARE: DR. HAO YU DDS

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	122300000X	Dentist	48413	CA

General Provider Information

NPI Number	:	1225030984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAO YU DDS

Provider Business Mailing Address
First Line	:	1520 N MOUNTAIN AVE
Second Line	:	SUITE 123
City	:	ONTARIO
State	:	CA
Zip	:	91762-1132
Country	:	US
Telephone Number	:	909-988-9690
Fax Number	:	909-988-5372

Provider Business Practice Location Address
First Line	:	1520 N MOUNTAIN AVE
Second Line	:	SUITE 123
City	:	ONTARIO
State	:	CA
Zip	:	91762-1132
Country	:	US
Telephone Number	:	909-988-9690
Fax Number	:	909-988-5372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	08/23/2007

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