Provider Demographics
NPI:1164887196
Name:EDDIE YUTI LO, MD, PC
Entity Type:Organization
Organization Name:EDDIE YUTI LO, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:YUTI
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-993-8349
Mailing Address - Street 1:2171 JUNIPERO SERRA BLVD STE 388
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1985
Mailing Address - Country:US
Mailing Address - Phone:650-993-8349
Mailing Address - Fax:650-993-8352
Practice Address - Street 1:2171 JUNIPERO SERRA BLVD STE 388
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1985
Practice Address - Country:US
Practice Address - Phone:650-993-8349
Practice Address - Fax:650-993-8352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102816207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty