Provider Demographics
NPI:1083323554
Name:HUANG, BONNIE YAN (LAC, DACU)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:YAN
Last Name:HUANG
Suffix:
Gender:F
Credentials:LAC, DACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8780 VALLEY BLVD
Mailing Address - Street 2:UNIT H
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770
Mailing Address - Country:US
Mailing Address - Phone:626-778-7788
Mailing Address - Fax:
Practice Address - Street 1:8780 VALLEY BLVD
Practice Address - Street 2:UNIT H
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770
Practice Address - Country:US
Practice Address - Phone:626-778-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18885171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist