Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 64394 | CA |
Y | 1223X0400X | Orthodontists | 64394 | CA |
NPI | 1023249299 |
---|---|
Provider Name | Yuyao B Chai |
First Address | Davis, CA 95618-6755 |
Second Address | Sacramento, CA 95831-3875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2009 |
Last Update Date | 18/06/2015 |