MEDICARE: LOUIS YANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1215605530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIS YANG MD

Provider Business Mailing Address
First Line	:	950 NORTHGATE DR STE 209
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3433
Country	:	US
Telephone Number	:	415-479-2373
Fax Number	:	415-472-6225

Provider Business Practice Location Address
First Line	:	950 NORTHGATE DR STE 209
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3433
Country	:	US
Telephone Number	:	415-479-2373
Fax Number	:	415-472-6225

Authorized Official
Title or Position	:	OPHTHALMOLOGIST
Name	:	DR. LOUIS JU FANG YANG
Credential	:	MD
Telephone Number	:	206-399-1273

Provider Enumeration Date	:	09/01/2021
Last Update Date	:	10/06/2021

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