Provider Demographics
NPI:1164431581
Name:PAN, YUE XING (LAC)
Entity Type:Individual
Prefix:
First Name:YUE XING
Middle Name:
Last Name:PAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E VALLEY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3554
Mailing Address - Country:US
Mailing Address - Phone:626-280-2121
Mailing Address - Fax:626-280-6618
Practice Address - Street 1:311 E VALLEY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3554
Practice Address - Country:US
Practice Address - Phone:626-280-2121
Practice Address - Fax:626-280-6618
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3904171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist