Healthcare Provider Details

I. General information

NPI: 1588107353
Provider Name (Legal Business Name): YANGDC CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 SAN RAMON RD
DUBLIN CA
94568-2338
US

IV. Provider business mailing address

7450 SAN RAMON RD
DUBLIN CA
94568-2338
US

V. Phone/Fax

Practice location:
  • Phone: 925-829-8484
  • Fax: 925-829-1806
Mailing address:
  • Phone: 925-829-8484
  • Fax: 925-829-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number29467
License Number StateCA

VIII. Authorized Official

Name: DR. JIM YANG
Title or Position: OWNER
Credential: DC
Phone: 925-829-8484