Provider Demographics
NPI:1275674343
Name:RAYMOND A. YU PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:RAYMOND A. YU PROFESSIONAL DENTAL CORPORATION
Other - Org Name:EL CERRITO DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-527-5944
Mailing Address - Street 1:10321 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3113
Mailing Address - Country:US
Mailing Address - Phone:510-527-5944
Mailing Address - Fax:510-527-5974
Practice Address - Street 1:10321 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3113
Practice Address - Country:US
Practice Address - Phone:510-527-5944
Practice Address - Fax:510-527-5974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty