MEDICARE: MRS. FANIS YIP

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	AC 15730	CA

General Provider Information

NPI Number	:	1851780522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FANIS YIP

Provider Business Mailing Address
First Line	:	23521 PASEO DE VALENCIA STE B13
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23521 PASEO DE VALENCIA STE B13
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3145
Country	:	US
Telephone Number	:	949-228-1969
Fax Number	:

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

Provider Enumeration Date	:	01/17/2015
Last Update Date	:	01/17/2015

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