Provider Demographics
NPI:1720371727
Name:YVONNE L. YAN, D.C., A CHIROPRACTIC PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:YVONNE L. YAN, D.C., A CHIROPRACTIC PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-676-9077
Mailing Address - Street 1:15190 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2209
Mailing Address - Country:US
Mailing Address - Phone:310-676-9077
Mailing Address - Fax:310-676-9078
Practice Address - Street 1:15190 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2209
Practice Address - Country:US
Practice Address - Phone:310-676-9077
Practice Address - Fax:310-676-9078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty