Provider Demographics
NPI:1780030478
Name:LI, ERIC YU KIT (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:YU KIT
Last Name:LI
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 1:1313 AUZERAIS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3478
Mailing Address - Country:US
Mailing Address - Phone:408-680-1793
Mailing Address - Fax:
Practice Address - Street 1:10430 S DE ANZA BLVD STE 170
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3000
Practice Address - Country:US
Practice Address - Phone:408-883-7943
Practice Address - Fax:888-812-6771
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011088742086S0122X
CAA1498602086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery