Provider Demographics
NPI:1952432312
Name:GAO, YUN (LAC)
Entity Type:Individual
Prefix:
First Name:YUN
Middle Name:
Last Name:GAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 PERALTA BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4851
Mailing Address - Country:US
Mailing Address - Phone:510-791-1388
Mailing Address - Fax:510-791-1388
Practice Address - Street 1:4101 PERALTA BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4851
Practice Address - Country:US
Practice Address - Phone:510-791-1388
Practice Address - Fax:510-791-1388
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5647171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist