Provider Demographics
NPI:1336236660
Name:YANG, BENJAMIN CHI-KUO (LAC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:CHI-KUO
Last Name:YANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:582 MARKET ST
Mailing Address - Street 2:SUITE 618
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-5301
Mailing Address - Country:US
Mailing Address - Phone:415-781-4010
Mailing Address - Fax:415-892-2210
Practice Address - Street 1:582 MARKET ST
Practice Address - Street 2:SUITE 618
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5301
Practice Address - Country:US
Practice Address - Phone:415-781-4010
Practice Address - Fax:415-892-2210
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1134171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist