Provider Demographics
NPI:1326221326
Name:CHENG, YAYUAN (DC, LAC)
Entity Type:Individual
Prefix:
First Name:YAYUAN
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92871-1073
Mailing Address - Country:US
Mailing Address - Phone:714-516-8111
Mailing Address - Fax:
Practice Address - Street 1:16960 BASTCHURY RD.
Practice Address - Street 2:SUITE A
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-9288
Practice Address - Country:US
Practice Address - Phone:714-516-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12138171100000X
CADC30889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist