Provider Demographics
NPI:1548594963
Name:YI, GILBERT
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:YI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 LOMITA BLVD
Mailing Address - Street 2:#101
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5024
Mailing Address - Country:US
Mailing Address - Phone:310-257-1725
Mailing Address - Fax:
Practice Address - Street 1:3525 LOMITA BLVD
Practice Address - Street 2:#101
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5024
Practice Address - Country:US
Practice Address - Phone:310-257-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13075171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist