MEDICARE: YAN WANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	16099	CA

General Provider Information

NPI Number	:	1053791038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAN WANG

Provider Business Mailing Address
First Line	:	1010 SPRINGFIELD DR
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-0314
Country	:	US
Telephone Number	:	408-207-8753
Fax Number	:

Provider Business Practice Location Address
First Line	:	1157 SARATOGA AVE # 207
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3423
Country	:	US
Telephone Number	:	408-207-8753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	05/14/2019

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Directions to “ YAN WANG ” Practice Location

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