Provider Demographics
NPI:1487137469
Name:GUO, YAN (L AC)
Entity type:Individual
Prefix:
First Name:YAN
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LONG GREEN CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2044
Mailing Address - Country:US
Mailing Address - Phone:443-889-4345
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERSON PLZ STE 350
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1157
Practice Address - Country:US
Practice Address - Phone:301-279-9009
Practice Address - Fax:301-279-9008
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02537171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist