Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 59211 | CA |
NPI | 1003167958 |
---|---|
Provider Name | Dr. You Chen Tao |
First Address | San Mateo, CA 94403-2808 |
Second Address | San Mateo, CA 94401-3840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2012 |
Last Update Date | 30/09/2020 |