Provider Demographics
NPI:1821401100
Name:YANG, LIN (LAC)
Entity Type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:957 DEWING AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4252
Mailing Address - Country:US
Mailing Address - Phone:510-827-2582
Mailing Address - Fax:510-900-6258
Practice Address - Street 1:957 DEWING AVE STE 7
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4252
Practice Address - Country:US
Practice Address - Phone:510-827-2582
Practice Address - Fax:510-900-6258
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15913171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist