Provider Demographics
NPI:1841556198
Name:LU, YUNG SHIH
Entity Type:Individual
Prefix:MR
First Name:YUNG
Middle Name:SHIH
Last Name:LU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 TULLY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1887
Mailing Address - Country:US
Mailing Address - Phone:408-607-3088
Mailing Address - Fax:
Practice Address - Street 1:1818 TULLY RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1887
Practice Address - Country:US
Practice Address - Phone:408-607-3088
Practice Address - Fax:408-270-7329
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14770171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist