Healthcare Provider Details

I. General information

NPI: 1740826072
Provider Name (Legal Business Name): YANG ZHOU MSTCM, MD(CHINA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 NORWICH WAY
SAN JOSE CA
95130-2054
US

IV. Provider business mailing address

4539 NORWICH WAY
SAN JOSE CA
95130-2054
US

V. Phone/Fax

Practice location:
  • Phone: 408-598-5027
  • Fax:
Mailing address:
  • Phone: 408-598-5027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number18735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: