MEDICARE: WANNI PERRIS YU

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	14485	CA

General Provider Information

NPI Number	:	1346997830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WANNI PERRIS YU

Provider Business Mailing Address
First Line	:	1807 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2501
Country	:	US
Telephone Number	:	626-905-3703
Fax Number	:

Provider Business Practice Location Address
First Line	:	1807 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2501
Country	:	US
Telephone Number	:	626-905-3703
Fax Number	:

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

Provider Enumeration Date	:	03/04/2022
Last Update Date	:	03/04/2022

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Directions to “ WANNI PERRIS YU ” Practice Location

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