Provider Demographics
NPI:1629134713
Name:LI, JIN YAN (MD(IN CHINA), BS)
Entity Type:Individual
Prefix:MRS
First Name:JIN YAN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD(IN CHINA), BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 WESTWOOD BLVD STE 2H
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6352
Mailing Address - Country:US
Mailing Address - Phone:310-474-3089
Mailing Address - Fax:310-474-3899
Practice Address - Street 1:2180 WESTWOOD BLVD STE 2H
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6352
Practice Address - Country:US
Practice Address - Phone:310-474-3089
Practice Address - Fax:310-474-3899
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 4135171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist