Provider Demographics
NPI:1295821122
Name:LI, YAN YAN (DC)
Entity type:Individual
Prefix:DR
First Name:YAN YAN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W WEDDELL DR
Mailing Address - Street 2:APT. 213
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-1576
Mailing Address - Country:US
Mailing Address - Phone:408-335-4584
Mailing Address - Fax:
Practice Address - Street 1:143 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5302
Practice Address - Country:US
Practice Address - Phone:408-335-4584
Practice Address - Fax:408-935-8250
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor