Healthcare Provider Details

I. General information

NPI: 1215514765
Provider Name (Legal Business Name): AMY YANG MD, A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SULLIVAN AVE FL 8
DALY CITY CA
94015-2200
US

IV. Provider business mailing address

3450 SACRAMENTO ST STE 117
SAN FRANCISCO CA
94118-1914
US

V. Phone/Fax

Practice location:
  • Phone: 650-991-5400
  • Fax: 650-991-5499
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY YANG
Title or Position: OWNER
Credential: MD
Phone: 415-562-4770