Provider Demographics
NPI:1093163933
Name:YU, JUNDA
Entity Type:Individual
Prefix:
First Name:JUNDA
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E 8640 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-1532
Mailing Address - Country:US
Mailing Address - Phone:801-560-0796
Mailing Address - Fax:435-688-2848
Practice Address - Street 1:101 E 8640 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-1532
Practice Address - Country:US
Practice Address - Phone:801-560-0796
Practice Address - Fax:435-688-2848
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT88275991201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist