Provider Demographics
NPI:1568867737
Name:YAN, YU
Entity Type:Individual
Prefix:
First Name:YU
Middle Name:
Last Name:YAN
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 1:5385 WALNUT AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2605
Mailing Address - Country:US
Mailing Address - Phone:909-628-5880
Mailing Address - Fax:909-628-5882
Practice Address - Street 1:5385 WALNUT AVE STE 7
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2605
Practice Address - Country:US
Practice Address - Phone:909-628-5880
Practice Address - Fax:909-628-5882
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16197171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist