Provider Demographics
NPI:1710186895
Name:YANG, SIMIN
Entity Type:Individual
Prefix:MR
First Name:SIMIN
Middle Name:
Last Name:YANG
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 1:703 E CALIFORNIA BLVD
Mailing Address - Street 2:# 5
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3834
Mailing Address - Country:US
Mailing Address - Phone:626-487-6014
Mailing Address - Fax:626-395-7766
Practice Address - Street 1:770 S ARROYO PKWY
Practice Address - Street 2:SUTE 117
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3255
Practice Address - Country:US
Practice Address - Phone:626-487-6014
Practice Address - Fax:626-395-7766
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5737171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist