Provider Demographics
NPI:1548219009
Name:KAN, SHIRLEY SUK-YEE (LAC, PHARMD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:SUK-YEE
Last Name:KAN
Suffix:
Gender:F
Credentials:LAC, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20392 YEANDLE AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4421
Mailing Address - Country:US
Mailing Address - Phone:510-461-4393
Mailing Address - Fax:
Practice Address - Street 1:20392 YEANDLE AVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4421
Practice Address - Country:US
Practice Address - Phone:510-461-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10688171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist