Provider Demographics
NPI:1255462453
Name:YU, SU CHENG (LAC, PHD)
Entity type:Individual
Prefix:DR
First Name:SU CHENG
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 E 10TH ST
Mailing Address - Street 2:SUITE G-2
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-4058
Mailing Address - Country:US
Mailing Address - Phone:209-839-8188
Mailing Address - Fax:209-839-8666
Practice Address - Street 1:35 E 10TH ST
Practice Address - Street 2:SUITE G-2
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4058
Practice Address - Country:US
Practice Address - Phone:209-839-8188
Practice Address - Fax:209-839-8666
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8175171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist