Provider Demographics
NPI:1518332808
Name:KOUCH, YUE MOI (DVM)
Entity Type:Individual
Prefix:
First Name:YUE
Middle Name:MOI
Last Name:KOUCH
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:MOI
Other - Middle Name:YUE
Other - Last Name:KOUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DVM
Mailing Address - Street 1:5235 PANAMA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-5421
Mailing Address - Country:US
Mailing Address - Phone:626-329-2784
Mailing Address - Fax:
Practice Address - Street 1:1312 SUNSET DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2853
Practice Address - Country:US
Practice Address - Phone:925-754-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20866174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian