Organization
YIMENG MA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YIMENG MA (OWNER)
(626) 679-3530
Entity
Organization
Contact information
Practice address
561 WESTGATE ST, PASADENA, CA 91103-2824
(626) 679-3530
Mailing address
561 WESTGATE ST, PASADENA, CA 91103-2824
(626) 679-3530
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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