Provider Demographics
NPI:1891552592
Name:FANG, CHIH-YU
Entity Type:Individual
Prefix:
First Name:CHIH-YU
Middle Name:
Last Name:FANG
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 1:958 E EL CAMINO REAL # 314
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3739
Mailing Address - Country:US
Mailing Address - Phone:510-203-3236
Mailing Address - Fax:
Practice Address - Street 1:43195 MISSION BLVD STE B1
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5340
Practice Address - Country:US
Practice Address - Phone:510-203-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20012171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist