Provider Demographics
NPI:1952906976
Name:YICAWELL ACUPUNCTURE INC
Entity Type:Organization
Organization Name:YICAWELL ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YI
Authorized Official - Middle Name:
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-242-4968
Mailing Address - Street 1:42271 BLACOW RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4172
Mailing Address - Country:US
Mailing Address - Phone:408-242-4968
Mailing Address - Fax:
Practice Address - Street 1:40 N PARK VICTORIA DR STE F
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4600
Practice Address - Country:US
Practice Address - Phone:408-252-1863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty