MEDICARE: MRS. YULIYA O SMALIY LAC

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	AC14343	CA

General Provider Information

NPI Number	:	1205103470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YULIYA O SMALIY LAC

Provider Business Mailing Address
First Line	:	1729 ELLINCOURT DR APT 11
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-2176
Country	:	US
Telephone Number	:	626-799-2085
Fax Number	:

Provider Business Practice Location Address
First Line	:	13760 VICTORY BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-2324
Country	:	US
Telephone Number	:	818-922-7713
Fax Number	:	818-922-7785

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

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	01/04/2026

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