Basic Information
Provider Information
NPI: 1679791842
EntityType: 2
ReplacementNPI:  
OrganizationName: ALAN YANG, MD, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7096
Address2:  
City: STOCKTON
State: CA
PostalCode: 952670096
CountryCode: US
TelephoneNumber: 2099567725
FaxNumber: 2099567733
Practice Location
Address1: 450 STANYAN ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941171079
CountryCode: US
TelephoneNumber: 4156681000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/23/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: YANG
AuthorizedOfficialFirstName: ALAN
AuthorizedOfficialMiddleName: T
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 4156681000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home