Provider Demographics
NPI:1447001300
Name:PCC ACUPUNCTURE GROUP
Entity type:Organization
Organization Name:PCC ACUPUNCTURE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-244-7676
Mailing Address - Street 1:31740 RAILROAD CANYON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-9490
Mailing Address - Country:US
Mailing Address - Phone:951-244-7676
Mailing Address - Fax:951-244-5757
Practice Address - Street 1:31740 RAILROAD CANYON RD STE 3
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-9490
Practice Address - Country:US
Practice Address - Phone:951-244-7676
Practice Address - Fax:951-244-5757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty