Provider Demographics
NPI:1174630800
Name:MAO, GUO YING (LAC)
Entity Type:Individual
Prefix:DR
First Name:GUO
Middle Name:YING
Last Name:MAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:DR
Other - First Name:ROGER
Other - Middle Name:GY
Other - Last Name:MAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:9724 CORTADA ST APT C
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-1218
Mailing Address - Country:US
Mailing Address - Phone:626-350-4322
Mailing Address - Fax:626-350-4322
Practice Address - Street 1:408 S. ROSEMEAD BLVD.
Practice Address - Street 2:SUITE 1
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107
Practice Address - Country:US
Practice Address - Phone:626-585-9898
Practice Address - Fax:626-585-9898
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9898171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist