Provider Demographics
NPI:1326152406
Name:YUEN, PETER (PHD, LAC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:YUEN
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E OLIVE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-2833
Mailing Address - Country:US
Mailing Address - Phone:909-792-1003
Mailing Address - Fax:909-792-1009
Practice Address - Street 1:112 E OLIVE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5281
Practice Address - Country:US
Practice Address - Phone:909-792-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC196171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist