Healthcare Provider Details

I. General information

NPI: 1821434010
Provider Name (Legal Business Name): YX MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2013
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4305 TORRANCE BLVD STE 306
TORRANCE CA
90503-4409
US

IV. Provider business mailing address

4305 TORRANCE BLVD STE 306
TORRANCE CA
90503-4409
US

V. Phone/Fax

Practice location:
  • Phone: 310-530-5678
  • Fax: 310-370-1206
Mailing address:
  • Phone: 310-530-5678
  • Fax: 310-370-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8554
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG33010
License Number StateCA

VIII. Authorized Official

Name: MRS. XIAOMING ANI
Title or Position: OWNER
Credential:
Phone: 310-530-5678