Provider Demographics
NPI:1417000928
Name:CHONA FRIAS YU DDS INC.
Entity Type:Organization
Organization Name:CHONA FRIAS YU DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHONA
Authorized Official - Middle Name:FRIAS
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-982-1435
Mailing Address - Street 1:2256 COLORADO BLVD
Mailing Address - Street 2:STE.111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1164
Mailing Address - Country:US
Mailing Address - Phone:323-982-1435
Mailing Address - Fax:323-982-1485
Practice Address - Street 1:2256 COLORADO BLVD
Practice Address - Street 2:STE.111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1164
Practice Address - Country:US
Practice Address - Phone:323-982-1435
Practice Address - Fax:323-982-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA460031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty