Provider Demographics
NPI:1063961258
Name:YU, SHOUBIN (L AC OMD)
Entity type:Individual
Prefix:
First Name:SHOUBIN
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:L AC OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:530 E LOS ANGELES AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2081
Mailing Address - Country:US
Mailing Address - Phone:805-777-8491
Mailing Address - Fax:805-523-8555
Practice Address - Street 1:530 E LOS ANGELES AVE
Practice Address - Street 2:STE 104
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2081
Practice Address - Country:US
Practice Address - Phone:805-777-8491
Practice Address - Fax:805-523-8555
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17258171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist