MEDICARE: YANLU YAN

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	AC5355	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	YANLUYAN	OTHER	CA	ACUPUNCTURIST

General Provider Information

NPI Number	:	1437214905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANLU YAN

Provider Business Mailing Address
First Line	:	1638 B ST
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94541-3020
Country	:	US
Telephone Number	:	510-733-0202
Fax Number	:	510-247-9438

Provider Business Practice Location Address
First Line	:	1638 B ST
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94541-3020
Country	:	US
Telephone Number	:	510-733-0202
Fax Number	:	510-247-9438

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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Directions to “ YANLU YAN ” Practice Location

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