Provider Demographics
NPI:1942686563
Name:BAY AREA ORIENTAL FAMILY PRACTICE, PA
Entity Type:Organization
Organization Name:BAY AREA ORIENTAL FAMILY PRACTICE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YALI
Authorized Official - Middle Name:
Authorized Official - Last Name:FAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-882-8373
Mailing Address - Street 1:5905 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3219
Mailing Address - Country:US
Mailing Address - Phone:813-882-8373
Mailing Address - Fax:
Practice Address - Street 1:5905 WEBB RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3219
Practice Address - Country:US
Practice Address - Phone:813-882-8373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty