Provider Demographics
NPI:1255457255
Name:LU, YUNYONG (LAC)
Entity type:Individual
Prefix:MR
First Name:YUNYONG
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:MR
Other - First Name:HIDENORI
Other - Middle Name:
Other - Last Name:ANTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:20445 PACIFICA DR
Mailing Address - Street 2:STE A1
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3017
Mailing Address - Country:US
Mailing Address - Phone:408-996-7358
Mailing Address - Fax:408-996-7358
Practice Address - Street 1:20445 PACIFICA DR
Practice Address - Street 2:STE A1
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3017
Practice Address - Country:US
Practice Address - Phone:408-996-7358
Practice Address - Fax:408-996-7358
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9851171100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist