Provider Demographics
NPI:1649298647
Name:YAN, BENG YUE
Entity type:Individual
Prefix:MR
First Name:BENG
Middle Name:YUE
Last Name:YAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 BUCHANAN RD STE B5
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4233
Mailing Address - Country:US
Mailing Address - Phone:925-757-9012
Mailing Address - Fax:925-757-9090
Practice Address - Street 1:1104 BUCHANAN RD STE B5
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4233
Practice Address - Country:US
Practice Address - Phone:925-757-9012
Practice Address - Fax:925-757-9090
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist