Provider Demographics
NPI:1730572355
Name:YUO, PETER (LVN)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:YUO
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GEORGIAN RD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3546
Mailing Address - Country:US
Mailing Address - Phone:818-434-3237
Mailing Address - Fax:818-330-9963
Practice Address - Street 1:500 GEORGIAN RD
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-3546
Practice Address - Country:US
Practice Address - Phone:818-434-3237
Practice Address - Fax:818-330-9963
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6002514740376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator