Provider Demographics
NPI:1679591655
Name:YE, LIN (LAC)
Entity Type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:YE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3246 MCKINLEY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6765
Mailing Address - Country:US
Mailing Address - Phone:408-247-3232
Mailing Address - Fax:408-247-3203
Practice Address - Street 1:3246 MCKINLEY DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6765
Practice Address - Country:US
Practice Address - Phone:408-247-3232
Practice Address - Fax:408-247-3203
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC-6692171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC-6692OtherL.AC.
CACA0066920OtherBLUE SHIELD OF CA