Provider Demographics
NPI:1114418837
Name:LAI, YU YAO (LAC)
Entity Type:Individual
Prefix:
First Name:YU YAO
Middle Name:
Last Name:LAI
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 1:20627 GOLDEN SPRINGS DR # J
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4814
Mailing Address - Country:US
Mailing Address - Phone:909-598-1588
Mailing Address - Fax:909-598-1588
Practice Address - Street 1:20627 GOLDEN SPRINGS DR # J
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789
Practice Address - Country:US
Practice Address - Phone:909-598-1588
Practice Address - Fax:909-598-1588
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC18007171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist