Healthcare Provider Details

I. General information

NPI: 1023375896
Provider Name (Legal Business Name): YIN YANG ACUPUNCTURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 KUEHNER DR SUITE 113
SIMI VALLEY CA
93063-3900
US

IV. Provider business mailing address

2315 KUEHNER DR SUITE 113
SIMI VALLEY CA
93063-3900
US

V. Phone/Fax

Practice location:
  • Phone: 805-578-8850
  • Fax: 805-578-8852
Mailing address:
  • Phone: 805-578-8850
  • Fax: 805-578-8852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11997
License Number StateCA

VIII. Authorized Official

Name: MRS. LIN LIN LI HEINE
Title or Position: OWNER/PRESIDENT
Credential: L.AC PHD.
Phone: 805-578-8850