Provider Demographics
NPI:1457926263
Name:LI, CHIA YU (DPT)
Entity Type:Individual
Prefix:
First Name:CHIA YU
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 CHRISTIE AVE APT 5413
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1048
Mailing Address - Country:US
Mailing Address - Phone:909-712-9202
Mailing Address - Fax:
Practice Address - Street 1:1350 S KING ST STE 300
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2066
Practice Address - Country:US
Practice Address - Phone:808-348-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL17379225100000X
MD28090225100000X
OR64000225100000X
HIPT-5187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist