Healthcare Provider Details

I. General information

NPI: 1407001449
Provider Name (Legal Business Name): ALEXANDER Q YANG, M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 OAKDALE ROAD
MODESTO CA
95355-4241
US

IV. Provider business mailing address

817 COFFEE ROAD C3
MODESTO CA
95355
US

V. Phone/Fax

Practice location:
  • Phone: 209-572-2700
  • Fax: 209-572-0151
Mailing address:
  • Phone: 209-529-9603
  • Fax: 209-529-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG84318
License Number StateCA

VIII. Authorized Official

Name: ALEXANDER QUANG YANG
Title or Position: PRESIDENT
Credential: MD
Phone: 209-572-2700