Provider Demographics
NPI:1295845691
Name:YU, MOSES JR (ACUPUNCTURE)
Entity Type:Individual
Prefix:MR
First Name:MOSES
Middle Name:
Last Name:YU
Suffix:JR
Gender:M
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2501
Mailing Address - Country:US
Mailing Address - Phone:626-255-7477
Mailing Address - Fax:213-483-2350
Practice Address - Street 1:1807 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:626-255-7477
Practice Address - Fax:213-483-2350
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA562579413OtherTAX IDENTIFICATION