Provider Demographics
NPI:1134645120
Name:WANG, YINAN
Entity Type:Individual
Prefix:MR
First Name:YINAN
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9449 N 90TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5063
Mailing Address - Country:US
Mailing Address - Phone:480-451-8880
Mailing Address - Fax:
Practice Address - Street 1:9449 N 90TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5063
Practice Address - Country:US
Practice Address - Phone:480-451-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1044171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist