Provider Demographics
NPI:1356716138
Name:LU, YIXI KEVIN (DPM)
Entity type:Individual
Prefix:DR
First Name:YIXI
Middle Name:KEVIN
Last Name:LU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:795 E. SECOND STREET
Mailing Address - Street 2:STE. 7
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1700
Mailing Address - Country:US
Mailing Address - Phone:909-706-3877
Mailing Address - Fax:909-706-3942
Practice Address - Street 1:795 E 2ND ST FL 2
Practice Address - Street 2:STE. 7
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-706-3877
Practice Address - Fax:909-706-3942
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-05
Last Update Date:2021-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPOD001288213ES0103X
CAE5723213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty