Provider Demographics
NPI:1952445926
Name:WANG, YU LAN (LAC)
Entity Type:Individual
Prefix:DR
First Name:YU
Middle Name:LAN
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:16221 SERRANO RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1755
Mailing Address - Country:US
Mailing Address - Phone:760-912-1929
Mailing Address - Fax:760-946-1381
Practice Address - Street 1:15080 7TH ST
Practice Address - Street 2:SUITE 11
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3865
Practice Address - Country:US
Practice Address - Phone:760-952-3800
Practice Address - Fax:760-245-9754
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 11207171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist