Provider Demographics
NPI:1013247899
Name:LI, SU-YU (MD)
Entity Type:Individual
Prefix:
First Name:SU-YU
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8599 HAVEN AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4849
Mailing Address - Country:US
Mailing Address - Phone:909-570-3125
Mailing Address - Fax:866-738-9647
Practice Address - Street 1:8599 HAVEN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4849
Practice Address - Country:US
Practice Address - Phone:909-570-3125
Practice Address - Fax:866-738-9647
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2014-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1288982085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology