Provider Demographics
NPI:1992961304
Name:JIN, YING JI (LAC)
Entity type:Individual
Prefix:
First Name:YING
Middle Name:JI
Last Name:JIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 W 7TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-3932
Mailing Address - Country:US
Mailing Address - Phone:213-385-7078
Mailing Address - Fax:
Practice Address - Street 1:2946 W 7TH ST
Practice Address - Street 2:STE D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-3932
Practice Address - Country:US
Practice Address - Phone:213-385-7078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7636171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist