Provider Demographics
NPI:1053666180
Name:CHAI, CHSU YUAN (LAC)
Entity Type:Individual
Prefix:
First Name:CHSU YUAN
Middle Name:
Last Name:CHAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 BERNAL RD
Mailing Address - Street 2:#106
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1343
Mailing Address - Country:US
Mailing Address - Phone:408-990-6733
Mailing Address - Fax:
Practice Address - Street 1:1095 BIRD AVE
Practice Address - Street 2:STE #1
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-1640
Practice Address - Country:US
Practice Address - Phone:408-990-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-15
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14483171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist