Provider Demographics
NPI:1932570629
Name:XIAOMAN YANG
Entity type:Organization
Organization Name:XIAOMAN YANG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:XIAOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-768-5275
Mailing Address - Street 1:23030 LAKE FOREST DR
Mailing Address - Street 2:STE 206
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1331
Mailing Address - Country:US
Mailing Address - Phone:714-951-7268
Mailing Address - Fax:866-997-7080
Practice Address - Street 1:23030 LAKE FOREST DR
Practice Address - Street 2:STE 206
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1331
Practice Address - Country:US
Practice Address - Phone:714-951-7268
Practice Address - Fax:866-997-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13229171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1457749921OtherACUPUNCTURE