Provider Demographics
NPI:1376722017
Name:LO, EDDIE YUTI (MD)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:YUTI
Last Name:LO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 JUNIPERO SERRA BLVD
Mailing Address - Street 2:STE 388
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
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102816207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000OtherRES000