Provider Demographics
NPI:1912203720
Name:YU, TE CHUN (LAC)
Entity Type:Individual
Prefix:
First Name:TE CHUN
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 DESIRE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2970
Mailing Address - Country:US
Mailing Address - Phone:626-679-5189
Mailing Address - Fax:626-581-3450
Practice Address - Street 1:1722 DESIRE AVE STE 205
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2970
Practice Address - Country:US
Practice Address - Phone:626-679-5189
Practice Address - Fax:626-581-3450
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13792171100000X
CA32182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist