Provider Demographics
NPI:1790871754
Name:YIU, RUTH LO TAK (DC)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:LO TAK
Last Name:YIU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N BREA BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835
Mailing Address - Country:US
Mailing Address - Phone:714-529-1077
Mailing Address - Fax:714-529-3777
Practice Address - Street 1:2900 N BREA BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-529-1077
Practice Address - Fax:714-529-3777
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV10653Medicare UPIN