Provider Demographics
NPI:1720504970
Name:TAN, YUNQI (LAC, DAOM)
Entity type:Individual
Prefix:
First Name:YUNQI
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 GELLERT BLVD STE R
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2617
Mailing Address - Country:US
Mailing Address - Phone:415-810-8896
Mailing Address - Fax:
Practice Address - Street 1:345 GELLERT BLVD STE R
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2617
Practice Address - Country:US
Practice Address - Phone:415-810-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17721171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist