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General NPI Number Information
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NPI Number | 1104211440
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Entity Type | Organization
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Legal Business Name | YO SAN UNIVERSITY OF TRADITIONAL CHINESE MEDICINE INC.
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 13315 W WASHINGTON BLVD SUITE 200
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City | LOS ANGELES
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State | CA
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Zip | 90066-5169
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Country | US
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Telephone | 310-577-3006
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Fax |
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Provider Business Mailing Address
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Address Line | 13315 W. WASHINGTON BLVD. SUITE 200
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City | LOS ANGELES
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State | CA
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Zip | 90066-5162
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Country | US
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Telephone | 310-577-3006
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Fax |
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Authorized Official
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Title or Position | CONTROLLER / BURSAR
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Name | SHUILAN MARIANI MAY
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Credential |
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Telephone | 310-577-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 51464
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License Number State | CA
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