Healthcare Provider Details

I. General information

NPI: 1982161311
Provider Name (Legal Business Name): MISS LIYING YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N MILPITAS BLVD
MILPITAS CA
95035-2727
US

IV. Provider business mailing address

1717 N MILPITAS BLVD
MILPITAS CA
95035-2727
US

V. Phone/Fax

Practice location:
  • Phone: 650-799-9837
  • Fax:
Mailing address:
  • Phone: 650-799-9837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC18333
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: