Provider Demographics
NPI:1265696785
Name:CHEN, YUELAN
Entity type:Individual
Prefix:
First Name:YUELAN
Middle Name:
Last Name:CHEN
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 1:1850 HACIENDA DR STE 15
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-4545
Mailing Address - Country:US
Mailing Address - Phone:760-806-0064
Mailing Address - Fax:760-806-4450
Practice Address - Street 1:1850 HACIENDA DR STE 15
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-4545
Practice Address - Country:US
Practice Address - Phone:760-806-0064
Practice Address - Fax:760-806-4450
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9705171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist