Healthcare Provider Details

I. General information

NPI: 1669879789
Provider Name (Legal Business Name): ZHONG YI YAO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2014
Last Update Date: 12/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S COAST HWY STE 312
LAGUNA BEACH CA
92651-2971
US

IV. Provider business mailing address

28345 VIA ALFONSE
LAGUNA NIGUEL CA
92677-7060
US

V. Phone/Fax

Practice location:
  • Phone: 949-407-8728
  • Fax: 949-407-8740
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberAC15400
License Number StateCA

VIII. Authorized Official

Name: MRS. ANNE FRANCES DAVIES
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 949-407-8728