Provider Demographics
NPI:1851830392
Name:YAN, HOWARD (PT, DPT, COMT)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:YAN
Suffix:
Gender:M
Credentials:PT, DPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16271 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4102
Mailing Address - Country:US
Mailing Address - Phone:714-375-1755
Mailing Address - Fax:714-937-5175
Practice Address - Street 1:16271 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4102
Practice Address - Country:US
Practice Address - Phone:714-375-1755
Practice Address - Fax:714-375-1757
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22806225100000X
CAPT293241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT293241OtherPHYSICAL THERAPY BOARD OF CALIFORNIA