MEDICARE: MRS. YEONG HOE HEO L.AC

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	10697	CA

General Provider Information

NPI Number	:	1831323567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YEONG HOE HEO L.AC

Provider Business Mailing Address
First Line	:	14764 BEACH BLVD
Second Line	:
City	:	LA MIRADA
State	:	CA
Zip	:	90638-4250
Country	:	US
Telephone Number	:	714-523-8000
Fax Number	:	714-523-8000

Provider Business Practice Location Address
First Line	:	14764 BEACH BLVD
Second Line	:
City	:	LA MIRADA
State	:	CA
Zip	:	90638-4250
Country	:	US
Telephone Number	:	714-523-8000
Fax Number	:	714-523-8000

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

Provider Enumeration Date	:	05/09/2009
Last Update Date	:	05/09/2009

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