MEDICARE: YANG LI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC17573	CA

General Provider Information

NPI Number	:	1063941482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANG LI

Provider Business Mailing Address
First Line	:	1520 SOUTHWEST EXPY APT 141
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-3984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 SOUTHWEST EXPY UNIT 141
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126
Country	:	US
Telephone Number	:	408-889-3998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	06/08/2017

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Directions to “ YANG LI ” Practice Location

Language	Start Address	Practice Location

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