Provider Demographics
NPI:1407292279
Name:YU, FANGSHU (L AC)
Entity Type:Individual
Prefix:
First Name:FANGSHU
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21119 RED FIR CT
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4254
Mailing Address - Country:US
Mailing Address - Phone:408-707-2694
Mailing Address - Fax:
Practice Address - Street 1:390 BRIDGE PKWY STE 210
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1061
Practice Address - Country:US
Practice Address - Phone:408-707-2694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15321171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist