Healthcare Provider Details

I. General information

NPI: 1801050943
Provider Name (Legal Business Name): HUGH YANG D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 N WAYTE LN
FRESNO CA
93701-2124
US

IV. Provider business mailing address

2625 E DIVISADERO ST
FRESNO CA
93721-1431
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-5700
  • Fax: 559-459-6109
Mailing address:
  • Phone: 559-443-2682
  • Fax: 559-443-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A10111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: