Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 38237 | CA |
NPI | 1134251788 |
---|---|
Provider Name | Dr. Eugene Yuan |
First Address | San Luis Obispo, CA 93405-6470 |
Second Address | San Luis Obispo, CA 93405-6470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |