Healthcare Provider Details

I. General information

NPI: 1497913677
Provider Name (Legal Business Name): YAOHUI FANG ACUPUNCTURIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2008
Last Update Date: 05/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 CALIFORNIA ST UNIT B
ARCADIA CA
91006-3677
US

IV. Provider business mailing address

166 CALIFORNIA ST UNIT B
ARCADIA CA
91006-3677
US

V. Phone/Fax

Practice location:
  • Phone: 626-254-9362
  • Fax:
Mailing address:
  • Phone: 626-254-9362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4986
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: