Provider Demographics
NPI:1669529368
Name:LYU, PETER EUI-YOUNG (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:EUI-YOUNG
Last Name:LYU
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SUTTER ST., RM 1023
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-391-9230
Mailing Address - Fax:415-391-3020
Practice Address - Street 1:450 SUTTER ST., RM 1023
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-391-9230
Practice Address - Fax:415-391-3020
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery