Provider Demographics
NPI:1982892238
Name:YANG, GER RICHARD (L AC)
Entity Type:Individual
Prefix:
First Name:GER
Middle Name:RICHARD
Last Name:YANG
Suffix:
Gender:M
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 1:202 FASHION LANE SUITE 107
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3302
Mailing Address - Country:US
Mailing Address - Phone:714-697-0931
Mailing Address - Fax:
Practice Address - Street 1:202 FASHION LANE SUITE 107
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3302
Practice Address - Country:US
Practice Address - Phone:714-697-0931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10526171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist