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General NPI Number Information
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NPI Number | 1669910352
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE AVENUE
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 234 N EL MOLINO AVE SUITE 202
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City | PASADENA
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State | CA
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Zip | 91101-1687
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Country | US
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Telephone | 626-734-7779
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Fax |
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Provider Business Mailing Address
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Address Line | 234 N EL MOLINO AVE SUITE 202
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City | PASADENA
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State | CA
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Zip | 91101-1687
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Country | US
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Telephone | 626-734-7779
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Fax |
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Authorized Official
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Title or Position | OWNER / ACUPUNCTURIST
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Name | PETER YEUNG
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Credential | LAC
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Telephone | 626-660-9541
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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 | 13541
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License Number State | CA
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