Healthcare Provider Details

I. General information

NPI: 1598682189
Provider Name (Legal Business Name): KWANGWOONG YANG L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16960 BASTANCHURY RD STE G
YORBA LINDA CA
92886-1711
US

IV. Provider business mailing address

16960 BASTANCHURY RD STE G
YORBA LINDA CA
92886-1711
US

V. Phone/Fax

Practice location:
  • Phone: 562-991-4745
  • Fax:
Mailing address:
  • Phone: 562-991-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: