Provider Demographics
NPI:1023553567
Name:YANG, TA SHING (LAC)
Entity Type:Individual
Prefix:
First Name:TA SHING
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:TA
Other - Middle Name:HSING
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:688 RADBURY PL
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1414 S AZUSA AVE STE B-5
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-4088
Practice Address - Country:US
Practice Address - Phone:626-727-6032
Practice Address - Fax:626-270-5168
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist