Provider Demographics
NPI:1588980239
Name:YEH, LORY (DPT, OCS, MSAOM, LAC)
Entity type:Individual
Prefix:DR
First Name:LORY
Middle Name:
Last Name:YEH
Suffix:
Gender:F
Credentials:DPT, OCS, MSAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1719
Mailing Address - Country:US
Mailing Address - Phone:626-551-1108
Mailing Address - Fax:
Practice Address - Street 1:615 E UNION ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1719
Practice Address - Country:US
Practice Address - Phone:626-551-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14972171100000X
CAPT35876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT35876OtherPHYSICAL THERAPY BOARD OF CALIFORNIA
CAAC14972OtherCALIFORNIA ACUPUNCTURE BOARD