Provider Demographics
NPI:1467779595
Name:YEUNG, PETER (LAC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:YEUNG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 N EL MOLINO AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1687
Mailing Address - Country:US
Mailing Address - Phone:626-734-7779
Mailing Address - Fax:
Practice Address - Street 1:234 N EL MOLINO AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1687
Practice Address - Country:US
Practice Address - Phone:626-734-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13541171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist