Provider Demographics
NPI:1932280344
Name:YE, LIYUN (L AC)
Entity Type:Individual
Prefix:
First Name:LIYUN
Middle Name:
Last Name:YE
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2742 CONCORD BLVD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2607
Mailing Address - Country:US
Mailing Address - Phone:925-609-8822
Mailing Address - Fax:925-363-0099
Practice Address - Street 1:2742 CONCORD BLVD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2607
Practice Address - Country:US
Practice Address - Phone:925-609-8822
Practice Address - Fax:925-363-0099
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7554171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0075540Medicaid