Provider Demographics
NPI:1154419711
Name:YAN, ANNA C (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:C
Last Name:YAN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2135
Mailing Address - Country:US
Mailing Address - Phone:626-292-6778
Mailing Address - Fax:626-292-6950
Practice Address - Street 1:9414 LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2135
Practice Address - Country:US
Practice Address - Phone:626-292-6778
Practice Address - Fax:626-292-6950
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5237171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0052370Medicaid