Healthcare Provider Details

I. General information

NPI: 1538136007
Provider Name (Legal Business Name): MARIAN C YEARGIN RN LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33315 SANTIAGO RD
ACTON CA
93510
US

IV. Provider business mailing address

7041 STEARNS ST
LONG BEACH CA
90815
US

V. Phone/Fax

Practice location:
  • Phone: 661-269-2020
  • Fax: 661-269-2120
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC9344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: