Provider Demographics
NPI:1851005102
Name:GE, SIYUN
Entity Type:Individual
Prefix:
First Name:SIYUN
Middle Name:
Last Name:GE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 BIKINI AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2907
Mailing Address - Country:US
Mailing Address - Phone:669-377-5899
Mailing Address - Fax:
Practice Address - Street 1:5043 GRAVES AVE STE F
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5103
Practice Address - Country:US
Practice Address - Phone:669-377-5899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19652171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist