Provider Demographics
NPI:1497266225
Name:CHUANG, YITING
Entity Type:Individual
Prefix:
First Name:YITING
Middle Name:
Last Name:CHUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 SCOTT BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4138
Mailing Address - Country:US
Mailing Address - Phone:408-758-8925
Mailing Address - Fax:
Practice Address - Street 1:1765 SCOTT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4138
Practice Address - Country:US
Practice Address - Phone:408-758-8925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17805171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist