Healthcare Provider Details

I. General information

NPI: 1689726986
Provider Name (Legal Business Name): GWEN YAN YEE OMD, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 E ROMIE LN
SALINAS CA
93901-3128
US

IV. Provider business mailing address

228 E ROMIE LN
SALINAS CA
93901-3128
US

V. Phone/Fax

Practice location:
  • Phone: 831-754-5578
  • Fax: 831-771-0228
Mailing address:
  • Phone: 831-754-5578
  • Fax: 831-771-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number8956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: