Healthcare Provider Details

I. General information

NPI: 1982908463
Provider Name (Legal Business Name): MARCOS YANG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 TEJON PL
PALOS VERDES ESTATES CA
90274-1204
US

IV. Provider business mailing address

310 TEJON PL
PALOS VERDES ESTATES CA
90274-1204
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-2403
  • Fax: 310-375-9652
Mailing address:
  • Phone: 310-375-2403
  • Fax: 310-375-9652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA49035
License Number StateCA

VIII. Authorized Official

Name: MARCOS Y. YANG
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 310-375-2403