Healthcare Provider Details

I. General information

NPI: 1740763580
Provider Name (Legal Business Name): YO SAN UNIVERSITY OF TRADITIONAL CHINESE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13315 W WASHINGTON BLVD SUITE 200
LOS ANGELES CA
90066
US

IV. Provider business mailing address

13315 W WASHINGTON BLVD
LOS ANGELES CA
90066
US

V. Phone/Fax

Practice location:
  • Phone: 310-577-3006
  • Fax:
Mailing address:
  • Phone: 310-577-3000
  • Fax: 310-577-3033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE LAU
Title or Position: PRESIDENT/CEO
Credential:
Phone: 310-577-3000