Healthcare Provider Details

I. General information

NPI: 1447842463
Provider Name (Legal Business Name): CHIH FANG YANG LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIVIAN YANG LAC

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 COLORADO AVE STE 100
PALO ALTO CA
94303-3913
US

IV. Provider business mailing address

719 COLORADO AVE STE 100
PALO ALTO CA
94303-3913
US

V. Phone/Fax

Practice location:
  • Phone: 909-905-7288
  • Fax:
Mailing address:
  • Phone: 909-905-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number19002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: